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Top Managed Care Contracting Clauses
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Book Synopsis Top Managed Care Contracting Clauses by : Peter Robert Fisk
Download or read book Top Managed Care Contracting Clauses written by Peter Robert Fisk and published by HC Pro, Inc.. This book was released on 2007 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a provider, your survival hinges on your ability to maximize reimbursements from managed care contracts and control access to agreed-upon discounts. But money lost at the time of service or through the collection process is often determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated. Top Managed Care Contracting Clauses: A Toolkit for Providers contains practical strategies and tools for any organization facing the prospect of negotiating a new managed care contract.
Book Synopsis Compliance for Coding, Billing & Reimbursement by : Duane C. Abbey
Download or read book Compliance for Coding, Billing & Reimbursement written by Duane C. Abbey and published by CRC Press. This book was released on 2008-04-02 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA’s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a supplier. Even more troubling is the need to alter claims to meet specific requirements that may conflict with national standards. Far from being a benign issue, differing guidelines can lead to false claims with financial and even criminal implications. Compliance for Coding, Billing & Reimbursement, Second Edition: A Systematic Approach to Developing a Comprehensive Program provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes that seem to force providers to choose between being paid and being compliant. Fully revised to account for recent changes and evolving terminology, this unique and accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships. Based on 25 years of direct client consultation and drawing on teaching techniques developed in highly successful workshops, Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource – Addresses the seven key elements promulgated by the OIG for any compliance program Discusses numerous types of compliance issues for all type of healthcare providers Offers access to online resources that provide continually updated information Cuts through the morass of terminology and acronyms with a comprehensive glossary Includes downloadable resources packed with regulations and information In addition to offering salient information illustrated by case studies, Dr, Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance.
Author :United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment Publisher : ISBN 13 : Total Pages :324 pages Book Rating :4.3/5 (121 download)
Book Synopsis Contract Issues and Quality Standards for Managed Care by : United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
Download or read book Contract Issues and Quality Standards for Managed Care written by United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment and published by . This book was released on 1996 with total page 324 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Essentials of Managed Health Care by : Peter Reid Kongstvedt
Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Managed Care : Explicit Gag Clauses Not Found in HMO Contracts, But Physician Concerns Remain by : United States. General Accounting Office
Download or read book Managed Care : Explicit Gag Clauses Not Found in HMO Contracts, But Physician Concerns Remain written by United States. General Accounting Office and published by . This book was released on 1997 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Revenue Cycle Management by : HCPro (Firm)
Download or read book Revenue Cycle Management written by HCPro (Firm) and published by HC Pro, Inc.. This book was released on 2006 with total page 155 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Managed Care Contracting Handbook by : Maria K. Todd
Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer
Book Synopsis Managing the Risks of Managed Care by : Barbara J. Youngberg
Download or read book Managing the Risks of Managed Care written by Barbara J. Youngberg and published by Jones & Bartlett Learning. This book was released on 1995 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: The dominance of managed care is spreading quickly and risk managers are suddenly faced with major new challenges. With Managing the Risks of Managed Care, the risk manager will learn about risk management challenges in an integrated delivery system. The book also presents expert analysis on issues like contracting, peer review, ethical dilemmas, antitrust and more.
Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt
Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
Book Synopsis Comprehensive Financial Planning Strategies for Doctors and Advisors by : David Edward Marcinko
Download or read book Comprehensive Financial Planning Strategies for Doctors and Advisors written by David Edward Marcinko and published by CRC Press. This book was released on 2014-12-09 with total page 748 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on the expertise of multi-degreed doctors, and multi-certified financial advisors, Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical PlannersTM will shape the industry landscape for the next generation as the current ecosystem strives to keep pace. Traditional generic products and sales-driven advice will yield to a new breed of deeply informed financial advisor or Certified Medical PlannerTM. The profession is set to be transformed by "cognitive-disruptors" that will significantly impact the $2.8 trillion healthcare marketplace for those financial consultants serving this challenging sector. There will be winners and losers. The text, which contains 24 chapters and champions healthcare providers while informing financial advisors, is divided into four sections compete with glossary of terms, CMPTM curriculum content, and related information sources. For ALL medical providers and financial industry practitioners For NEW medical providers and financial industry practitioners For MID-CAREER medical providers and financial industry practitioners For MATURE medical providers and financial industry practitioners Using an engaging style, the book is filled with authoritative guidance and healthcare-centered discussions, providing the tools and techniques to create a personalized financial plan using professional advice. Comprehensive coverage includes topics likes behavioral finance, modern portfolio theory, the capital asset pricing model, and arbitrage pricing theory; as well as insider insights on commercial real estate; high frequency trading platforms and robo-advisors; the Patriot and Sarbanes–Oxley Acts; hospital endowment fund management, ethical wills, giving, and legacy planning; and divorce and other special situations. The result is a codified "must-have" book, for all health industry participants, and those seeking advice from the growing cadre of financial consultants and Certified Medical PlannersTM who seek to "do well by doing good," dispensing granular physician-centric financial advice: Omnia pro medicus-clientis. RAISING THE BAR The informed voice of a new generation of fiduciary advisors for healthcare
Book Synopsis Quality Health-Care Coalition Act of 1999 by : United States. Congress. House. Committee on the Judiciary
Download or read book Quality Health-Care Coalition Act of 1999 written by United States. Congress. House. Committee on the Judiciary and published by . This book was released on 2000 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Essentials of Managed Health Care by :
Download or read book Essentials of Managed Health Care written by and published by Jones & Bartlett Publishers. This book was released on 2013 with total page 715 pages. Available in PDF, EPUB and Kindle. Book excerpt: Peter Kongstvedt provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.
Book Synopsis The Risk Manager's Desk Reference by : Barbara J. Youngberg
Download or read book The Risk Manager's Desk Reference written by Barbara J. Youngberg and published by Jones & Bartlett Learning. This book was released on 1998 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Risk Manager's Desk Reference, Second Edition is the definitive guide to ensure quality in your organization and save thousands of dollars in costly lawsuits. It puts at your fingertips the information you need on integrating quality assurance and risk management, understanding risk management in a managed care environment, and program development. With this book you learn how to integrate patient support services and facilitate physician participation. This handy reference offers concise information on your most challenging concerns and various ethical issues.
Book Synopsis Rationing Sanity by : James Lindemann Nelson
Download or read book Rationing Sanity written by James Lindemann Nelson and published by Georgetown University Press. This book was released on 2003-12-12 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. Rationing Sanity is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care. How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. Rationing Sanity integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care—the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill—but also how we may find more just and humane treatment for those afflicted.
Book Synopsis The Secret Life of Families by : Evan Imber-Black
Download or read book The Secret Life of Families written by Evan Imber-Black and published by Bantam. This book was released on 2009-08-19 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: Secrets come in all shapes and sizes. And for families as well as individuals, they are built on a complex web of shifting motives and emotions. But today, when personal revelations are posted on the Internet or sensationalized on afternoon talk shows, we risk losing touch with how important secrets are--how they are used and abused, their power to harm and heal. In this important work, Evan Imber-Black explores the nature of secrets, helping us understand: The distinction between healthy privacy and toxic secrecy What to tell--and not to tell--young children How to safely confront a family "zone of silence" Why adolescents need to have some secrets--and where to draw the line The effect of "official" secrets, like sealed adoption records and medical testing What to consider before revealing an important secret And much more Filled with moving first-person stories, The Secret Life of Families provides perspective on some of today's most sensitive personal and social issues. Giving voice to our deepest fears and to our power to overcome them, this is a book that will be talked about for years to come.
Author :United States. Congress. House. Committee on Ways and Means. Subcommittee on Health Publisher : ISBN 13 : Total Pages :152 pages Book Rating :4.0/5 ( download)
Book Synopsis H.R. 2976, the "Patient Right to Know Act of 1996" by : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Download or read book H.R. 2976, the "Patient Right to Know Act of 1996" written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1998 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Challenge of Regulating Managed Care by : John Eugene Billi
Download or read book The Challenge of Regulating Managed Care written by John Eugene Billi and published by University of Michigan Press. This book was released on 2001-11-08 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: DIVA rare insight into the views of major stakeholders in the debate about oversight of the managed-care industry /div
