This is an excellent book that is a must read for all psychiatric residents and early career psychiatrists. Dr. Fauman presents a well-organized and succinct review of how to document and present the clinical care of a psychiatric patient to a managed care reviewer. Dr. Fauman illustrates common pitfalls in reviewing cases and provides psychiatrists with sound strategies to avoid these common errors. The rich clinical vignettes illustrate his points and make this a readable book. The cases that are discussed reflect the clinical ambiguity of psychiatric care and Dr. Fauman provides strategies for documenting and discussing such cases in a way that reflects his own extensive clinical experience. Dr. Fauman's willingness to share his own clinical experiences gives the book credibility. William R. Dubin, M.D., Professor of Psychiatry, Temple University School of Medicine, Psychiatrist and Chief, Temple University Hospital-Episcopal Division, Philadelphia, Pennsylvania An excellent, straight-forward, readable, practical and succinct how-to-do-it manual for getting what you need for yourself and your patients... I recommend it highly. Howard S. Sudak, M.D., Clinical Professor, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

For many psychiatrists and other mental health professionals, the clinical review is the most burdensome and disagreeable part of managed care. In that review clinicians are asked by a representative of the managed care company to justify their patient's need for care and to defend the treatment they are providing. Clinicians usually feel at a disadvantage in these discussions because they are never quite sure what information will convince the reviewer to approve the patient's care. The goal of this text is to teach psychiatrists, mental health professionals and administrators how reviewers think and how to present a case in a manner that greatly increases the likelihood that a reviewer will approve the request for care. Beginning with four questions that must be answered in every managed care review, the author demonstrates how to: present effective requests for inpatient, partial hospital, and substance abuse care; negotiate with a reviewer to get approval for your patient's care; respond when you and the reviewer disagree; write clinical notes that substantiate your request for care; deal with unethical reviewers and managed care companies; and appeal denials of care. These and many other important issues are highlighted in brief vignettes illustrating a clinician's presentation of a patient's case and a typical reviewer's comments.