Managed care, or Scope hits the Sphinx.
This article presents a hypothetical fact pattern, in which preapproval for endoscopic retrograde cholangiopancreatography is denied by a managed care plan, to address the issues concerning potential liability for this decision. I described several risk management strategies for this situation designed to reduce the risk of a successful suit against a physician.
Plumeri
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PA
University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Sewell 08080, USA.
D016365:Liability, Legal; D008329:Managed Care Programs / Q000331:legislation & jurisprudence* / Q000592:standards; D012308:Risk Management; D014481:United States; D014600:Utilization Review