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Author : Hugh Greeley
Publisher :
ISBN 13 : 9781578390328
Total Pages : 179 pages
Book Rating : 4.3/5 (93 download)
Download or read book The Greeley Guide to Managed Care Credentialing written by Hugh Greeley and published by . This book was released on 1998-11-01 with total page 179 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 : Hugh Greeley
Publisher :
ISBN 13 : 9781578390311
Total Pages : 302 pages
Book Rating : 4.3/5 (93 download)
Download or read book The Greeley Guide to Medical Staff Credentialing written by Hugh Greeley and published by . This book was released on 1998-11 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 : Hugh P. Greeley
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (142 download)
Download or read book Performance-based Credentialing written by Hugh P. Greeley and published by . This book was released on 1986 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 : Garry Carneal
Publisher :
ISBN 13 : 9781930104051
Total Pages : 252 pages
Book Rating : 4.1/5 (4 download)
Download or read book The Credentialing Guide written by Garry Carneal and published by . This book was released on 2000 with total page 252 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 : Todd Sagin
Publisher : HC Pro, Inc.
ISBN 13 : 157839774X
Total Pages : 145 pages
Book Rating : 4.5/5 (783 download)
Download or read book The Greeley Company Guide to Medical Staff Bylaws written by Todd Sagin and published by HC Pro, Inc.. This book was released on 2006 with total page 145 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Joseph D. Cooper
Publisher : HC Pro, Inc.
ISBN 13 : 1601462336
Total Pages : 151 pages
Book Rating : 4.6/5 (14 download)
Download or read book The Greeley Guide to Medical Staff by Laws written by Joseph D. Cooper and published by HC Pro, Inc.. This book was released on 2008 with total page 151 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Hugh P. Greeley
Publisher : HC Pro, Inc.
ISBN 13 : 9781578394692
Total Pages : 134 pages
Book Rating : 4.3/5 (946 download)
Download or read book A Practical Guide to Assessing the Competency of Low-volume Providers written by Hugh P. Greeley and published by HC Pro, Inc.. This book was released on 2004 with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Veronica L. Rosas
Publisher :
ISBN 13 : 9781556457463
Total Pages : 0 pages
Book Rating : 4.4/5 (574 download)
Download or read book Physician Credentialing written by Veronica L. Rosas and published by . This book was released on 2015-07-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physician Credentialing: A Guide for Physician Office Staff Veronica L. Rosas, CPCS Credentialing providers in a physician practice is a confusing and time-consuming process that can seem daunting to even the most seasoned professional. Between managing the credentialing of new physicians to the mandatory recredentialing that must be undertaken every few years, it is imperative that practice-based credentialing coordinators are on top of their game. Covering the credentialing process for both hospitals and managed care organizations, Physician Credentialing: A Guide for Physician Office Staff is a must-have, practical, and easy-to-read guide for credentialing coordinators and office managers, whether they are brand-new or experienced. The book walks readers through the required forms, provides suggested timelines, details documentation requirements, and offers tips for multitasking and organizational strategies to maximize efficiency. There is even helpful professional guidance, including information on certification, networking, and education. This resource will help you do the following: Utilize your time efficiently by knowing all the steps in the credentialing process Stay on top of credentialing in the physician practice Plan ahead to manage credentialing for new physicians while maintaining credentials for current providers Table of Contents Preface Part 1: Introduction Chapter 1: Introduction to Credentialing Chapter 2: The Credentialing Application Chapter 3: The Managed Care Credentialing Process Chapter 4: The Hospital Credentialing Process Part 2: Introduction Chapter 5: Credentialing the New Provider Chapter 6: Recredentialing and Reappointment Chapter 7: Managed Care Organization Contracts Chapter 8: Multitasking Chapter 9: Not All Healthcare Organizations Are the Same Chapter 10: On Your Own but Not Alone: Networking, Education, and Certification Conclusion Appendixes Appendix A: Contracting Checklist Appendix B: Acronym List Who should read this book? Credentialing coordinator Credentialing professionals Physician practice manager Physician office manager Physician practice administrator Practice manager Office manager Practice administrator Business manager
Author : Fay Adrienne Rozovsky
Publisher : Aspen Publishers
ISBN 13 : 9780735564824
Total Pages : 0 pages
Book Rating : 4.5/5 (648 download)
Download or read book Health Care Credentialing written by Fay Adrienne Rozovsky and published by Aspen Publishers. This book was released on 2007-06-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: b>Health Care Credentialing, takes you far beyond the standard review of credentialing concerns, delivering insights into innovative ways to collect, process and assess credentialing information. No matter where you're conducting credentialing, this resource will help you keep pace with the latest ideas and approaches. Specifically, Health Care Credentialing will help you: Take into account complex laws, regulations, and accreditation standards as they apply to credentialing Handle disruptive care and clinical competency issues Access information for evaluating core competencies to be used in credentialing Stay up-to-date on relevant regulations, statutes, and accreditation standards Health Care Credentialing helps you address the critical issues in this important arena. This unique resource delivers: Coverage of credentialing for disaster management Innovative processes to upgrade clinical competencies outside the credentialing system Guidance on Board and IRB credentialing Innovative perspectives to address behavioral problems and disruptive individuals Cutting-edge approaches to "Pay-For-Performance" and credentialing Ahead-of-the-curve insights into credentialing and federal requirements such as the ADA Rehab Act Section 504 and EEOC guidance In addition, Health Care Credentialing will help you: Keep pace with credentialing standards and relevant state and federal requirements Launch important credentialing initiatives Implement alternative programs to address emerging credentialing issues And much more! Health Care Credentialing has been updated to include: New sections on: New ACOs: Physician-Hospital Alignment Changes in Medical Staff Structures Technology Utilization Competency Innovative Bylaws and Credentialing Advanced Diagnostic Imaging Credentialing Discussion of changes in the proposed rule for the Healthcare Integrity and Protection Data Bank (HIPDB) and the National Practitioner Data Bank (NPDB) Updated information on credentialing for advanced practice practitioners Updated information on telemedicine Discussion of the May 2012 revisions to the medical staff and nursing services Conditions of Participation Updated information on the final rule for screening and program requirements for ACOs Discussion of the following cases: Smigaj v. Yakima Valley Memorial Hospital West Florida Regional Medical Center v. See Gargiulo v. Baystate Health, Inc. Effective reversal of the Archuleta decision by Utah Code section 78B-3-425 Cawthorn v. Catholic Health Initiatives Iowa Corp. d/b/a/ Mercy Hospital Medical Center Appeal of Sternberg v. Nanticoke Memorial Hospital Jablonsky v. Sierra Kings Healthcare District Preau v. St. Paul Fire and Marine Insurance Company Lawnwood Medical Center Inc. v. Randall Seeger Smith v. Cleveland Clinic Gaalla v. Brown State of Rhode Island Department of Health Board of Medical Licensure and Discipline, In the matter of Alexandra Thran, MD Updated discussions of and references to The Joint Commission's 2012 Hospital Accreditation Standards
Author : Carol S. Cairns
Publisher :
ISBN 13 : 9781578399802
Total Pages : 182 pages
Book Rating : 4.3/5 (998 download)
Download or read book Verify and Comply written by Carol S. Cairns and published by . This book was released on 2007-01-01 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :
Publisher :
ISBN 13 :
Total Pages : 212 pages
Book Rating : 4.3/5 (91 download)
Download or read book First Do No Harm written by and published by . This book was released on 1999 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Beverly E. Pybus
Publisher : HC Pro, Inc.
ISBN 13 : 9781578394784
Total Pages : 482 pages
Book Rating : 4.3/5 (947 download)
Download or read book A Guide to AHP Credentialing written by Beverly E. Pybus and published by HC Pro, Inc.. This book was released on 2004 with total page 482 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Peter Reid Kongstvedt
Publisher :
ISBN 13 :
Total Pages : 1088 pages
Book Rating : 4.3/5 (91 download)
Download or read book The Managed Health Care Handbook written by Peter Reid Kongstvedt and published by . This book was released on 1996 with total page 1088 pages. Available in PDF, EPUB and Kindle. Book excerpt: Considered the 'bible' of the managed care industry, this third edition is greatly expanded with 30 new chapters and extensively updated-- double the size of the last edition! the Managed Health Care Handbook is a key strategic and operational resource for use in planning and decision-making. it includes first-hand advice from experienced managers on how to succeed in every aspect of managed care: quality management, claims and benefits administration, managing patient demand, As well as risk management, subacute care, physician compensation and much more! This seminal resource is a must for providers, purchasers, and payersfor everyone involved in the managed care industry.
