Read Books Online and Download eBooks, EPub, PDF, Mobi, Kindle, Text Full Free.
Download Credentialing In The Managed Care Environment full books in PDF, epub, and Kindle. Read online Credentialing In The Managed Care Environment ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
Author : Hugh P. Greeley
Publisher :
ISBN 13 :
Total Pages : 248 pages
Book Rating : 4.:/5 ( download)
Download or read book Credentialing in the Managed Care Environment written by Hugh P. Greeley and published by . This book was released on 1996 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Amy N. Niehaus
Publisher :
ISBN 13 : 9781683089650
Total Pages : 246 pages
Book Rating : 4.0/5 (896 download)
Download or read book Managed Care Credentialing written by Amy N. Niehaus and published by . This book was released on 2019 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: The role of the MSP is expanding to include payer enrollment and delegated credentialing responsibilities for managed care organizations. Traditionally siloed, MSPs are now beginning to take on both responsibilities, which means they must learn the nuances of managed care credentialing as well as the regulatory and accreditation requirements of NCQA, CMS, and URAC. Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs, and Delegated Entities provides the answers to MSPs' inevitable questions as they begin to manage the tasks of payer enrollment and delegated credentialing. Author Amy M. Niehaus guides readers through each payer's requirements, the differences between hospital and managed care credentialing, and how to help their organization establish delegated credentialing agreements and prepare for audits. As new and existing MSP responsibilities begin to collide, this resource also outlines ways MSPs can modify their current processes to reduce duplication of efforts and develop a comprehensive and compliant managed care credentialing program. Whether you are new to managed care credentialing or are taking on delegated credentialing responsibilities, this book will help you: Learn the regulatory and accreditation requirements related to managed care credentialing Streamline the provider enrollment process through delegation Meet your organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction Identify the differences between hospital and managed care credentialing
Author : Sheryl Deutsch
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834209336
Total Pages : 604 pages
Book Rating : 4.2/5 (93 download)
Download or read book The Credentialing Handbook written by Sheryl Deutsch and published by Jones & Bartlett Learning. This book was released on 1999 with total page 604 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Credentialing Handbook provides comprehensive, plain-English guida nce to understand and master the provider credentialing process in any health care setting. With sample forms, checklists, flowcharts, and c orrespondence, this practical guide walks you through every aspect of effective credentialing, appointment, and recredentialing. You'll lear n: key steps in the credentialing process; about express credentialin g models; how to credential allied health practitioners; typical time frames and tracking systems; pros and cons of delegating credentialin g, plus more.
Author : Amy M. Niehaus
Publisher :
ISBN 13 : 9781683080800
Total Pages : 0 pages
Book Rating : 4.0/5 (88 download)
Download or read book Credentialing for Managed Care written by Amy M. Niehaus and published by . This book was released on 2016-08-17 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Credentialing for Managed Care: Compliant Processes for Health Plan and Delegated Entities Amy M. Niehaus, CPMSM, CPCS, MBA New to managed care credentialing? Whether you work for a health plan or a hospital medical staff services department, this how-to guide answers all of your health plan credentialing and enrollment questions. Learn the regulatory and accreditation requirements related to managed care credentialing, including those from CMS, NCQA, and URAC. Author Amy M. Niehaus, CPMSM, CPCS, MBA, provides readers with the guidance to create a comprehensive and compliant credentialing program to support your health plan or to streamline your hospital's provider enrollment process through delegation. MSPs in all healthcare environments can benefit from understanding credentialing in the managed care world to support their organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction. This book will help you: - Understand NCQA, URAC, and CMS requirements for health plans - Develop a comprehensive and compliant managed care credentialing program - Establish delegated credentialing agreements - Audit credentials files - Recognize how payer credentialing requirements impact other healthcare organizations - Streamline provider enrollment through delegation - Identify the differences between hospital and managed care credentialing - Evaluate whether a credentials verification organization is right for your organization About the author: Amy M. Niehaus, CPMSM, CPCS, MBA, is a consultant with The Greeley Company, an industry-leading healthcare consulting firm. She has over 25 years' experience in the medical services and credentialing profession. In her current role, she advises clients in the areas of accreditation, regulatory compliance, credentialing, process simplification and redesign, credentialing technology, and credentials verification organizations (CVO) development and delegation. Niehaus has worked in multiple environments throughout her career, including acute care hospitals, CVOs, and managed care organizations (MCO). She has been a member of the National Association Medical Staff Services (NAMSS) since 1991 and achieved her CPMSM certification in 1992 and her CPCS certification in 2002. Niehaus is a NAMSS instructor and previously served as chair of its MCO Task Force, as well as chair and member of the NAMSS Education Committee. She is a former president of the Missouri Association Medical Staff Services and its greater St. Louis area chapter. Niehaus holds a bachelor's degree from the University of Missouri and a master's degree in business administration from Maryville University in St. Louis. Niehaus has developed and presented various programs to local and national audiences on topics such as credentialing and privileging processes; Joint Commission, National Committee for Quality Assurance (NCQA), and URAC accreditation standards; and delegation.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 030913319X
Total Pages : 191 pages
Book Rating : 4.3/5 (91 download)
Download or read book Health Professions Education written by Institute of Medicine and published by National Academies Press. This book was released on 2003-07-01 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Author : Roey Kirk
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834209121
Total Pages : 302 pages
Book Rating : 4.2/5 (91 download)
Download or read book Managing Outcomes, Process and Cost in a Managed Care Environment written by Roey Kirk and published by Jones & Bartlett Learning. This book was released on 1997 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nursing
Author : George B. Moseley
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834207356
Total Pages : 644 pages
Book Rating : 4.2/5 (73 download)
Download or read book Managed Care Strategies written by George B. Moseley and published by Jones & Bartlett Learning. This book was released on 1999 with total page 644 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.
Author : David B. Nash
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834203938
Total Pages : 280 pages
Book Rating : 4.2/5 (39 download)
Download or read book The Physician's Guide to Managed Care written by David B. Nash and published by Jones & Bartlett Learning. This book was released on 1994 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Author : Robert Tallon
Publisher : Practice Management Information Corporation
ISBN 13 :
Total Pages : 372 pages
Book Rating : 4.3/5 (91 download)
Download or read book Critical Concepts in Medical Practice Management written by Robert Tallon and published by Practice Management Information Corporation. This book was released on 1996 with total page 372 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309175054
Total Pages : 394 pages
Book Rating : 4.3/5 (91 download)
Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.
Author : Peter Reid Kongstvedt
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834217263
Total Pages : 1448 pages
Book Rating : 4.2/5 (172 download)
Download or read book The Managed Health Care Handbook written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2001 with total page 1448 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thoroughly revised and updated book provides a strategic and operational resource for use in planning and decision-making. The Handbook enables readers to fine-tune operation strategies by providing updates on critical managed care issues, insights to the complex managed care environment, and methods to gain and maintain cost-efficient, high quality health services. With 30 new chapters, it includes advice from managers in the field on how to succeed in every aspect of managed care including: quality management, claims and benefits administration, and managing patient demand. The Handbook is considered to be the standard resource for the managed care industry.
Author : Toni G. Cesta
Publisher :
ISBN 13 :
Total Pages : 456 pages
Book Rating : 4.3/5 (91 download)
Download or read book Survival Strategies for Nurses in Managed Care written by Toni G. Cesta and published by . This book was released on 2002 with total page 456 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book helps nurse managers define their role in the managed care system, learn strategies in financial management and focus on preventative care, while working on re-engineering patient care delivery systems, utilization, and outcomes management. It addresses topics from defining managed care andexplaining how a company works, to addressing ethical and legal issues that arise in the managed care system.
Author : Carol S. Cairns
Publisher : HC Pro, Inc.
ISBN 13 : 9781578393930
Total Pages : 174 pages
Book Rating : 4.3/5 (939 download)
Download or read book Verify and Comply written by Carol S. Cairns and published by HC Pro, Inc.. This book was released on 2004 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Cindy Gassiot
Publisher : Jones & Bartlett Learning
ISBN 13 : 0763784419
Total Pages : 523 pages
Book Rating : 4.7/5 (637 download)
Download or read book The Medical Staff Services Handbook written by Cindy Gassiot and published by Jones & Bartlett Learning. This book was released on 2011-08-24 with total page 523 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rev. ed. of: The medical staff services handbook / [edited by] Cindy A. Gassiot, Vicki L. Searcy, Christina W. Giles. c2007.
Author : Suzanne K. Powell
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 9780781718837
Total Pages : 548 pages
Book Rating : 4.7/5 (188 download)
Download or read book Case Management written by Suzanne K. Powell and published by Lippincott Williams & Wilkins. This book was released on 2000 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Second Edition of this comprehensive "how to" text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies.
Author : Steven F. Isenberg
Publisher : Thieme
ISBN 13 : 9780865776876
Total Pages : 374 pages
Book Rating : 4.7/5 (768 download)
Download or read book Managed Care, Outcomes, and Quality written by Steven F. Isenberg and published by Thieme. This book was released on 1998 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare
Author : James W. Saxton
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834210233
Total Pages : 328 pages
Book Rating : 4.2/5 (12 download)
Download or read book Managed Care Success written by James W. Saxton and published by Jones & Bartlett Learning. This book was released on 1998 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: The number of malpractice claims And The severity of final judgments could explode under managed care. Physicians and managed care organizations are on a collision course with malpractice when patient expectations are at an all-time high, and pressures of efficiency are constantly increasing. Defensive medicine -- doing procedures or additional tests, To protect the provider will no longer work. Utilization controls will penalize you, and ultimately, limit your practice. So what's the solution? to be successful in this evolving health care environment, you've got to change with it. You've got to be informed, be prepared, and ready to coexist with it. That's precisely why you need Managed Care Success: Reducing Risk While Increasing Patient Satisfaction . You'll learn how to work with -- not against -- managed care.
