What Is Physician Contracting In Healthcare Organizations

Author: Pamela H. Del Negro
ISBN: 9781627229661
Size: 54.41 MB
Format: PDF, Kindle
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This book describes some of the key legal and regulatory issues that lawyers should consider when drafting employment and clinical and administrative services agreements between physicians and healthcare organizations.

Contracting With Managed Care Organizations

Author: Joseph A. Welfeld, FACHE
Publisher: Jossey-Bass
ISBN: 9781556481567
Size: 13.83 MB
Format: PDF, Docs
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Additionally, Contracting with Managed Care Organizations provides a unique clause-by-clause comparison between an undesirable and a desirable hospital agreement with an MCO.

Managed Care Contracting

Author: Wendy Knight
Publisher: Aspen Pub
ISBN: 9780834208834
Size: 43.63 MB
Format: PDF, ePub, Mobi
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This book provides physician executives and medical group managers with a 'next generation' reference on the managed care contracting process.

Capitation In California

Author: Maurice J. Penner
Publisher: Maurice Penner
ISBN: 9781567930511
Size: 62.35 MB
Format: PDF, Docs
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This "from-the-trenches" guide can help you meet the challenges of forecasting a population's healthcare needs, building a provider panel, establishing financial incentives for providers, establishing information systems for managed care, ...

Physician Integration Alignment

Author: Maria K. Todd
Publisher: CRC Press
ISBN: 1439813094
Size: 13.77 MB
Format: PDF, Docs
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Filled with suggestions and ideas from successfully integrated practices, the book: Identifies industry drivers for the resurgence of integrated models and the need for aligned models Provides a look at the common characteristics of ...

Understanding Health Insurance A Guide To Billing And Reimbursement

Author: Michelle Green
Publisher: Cengage Learning
ISBN: 1111035180
Size: 39.58 MB
Format: PDF
View: 506
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Health maintenance organization (HMO). a. direct contract model b. group model
c. individual practice association (IPA) d. network model e. staff model 4. Point-of-
service plan (POS). 5. Preferred provider organization (PPO). 6. Triple option
plan. Exclusive Provider Organization (EPO) An exclusive provider organization (
EPO) is a managed care plan that provides benefits to subscribers who are
required to receive services from network providers. A network provider is a
physician or ...

Top Managed Care Contracting Clauses

Author: Robert Fisk
Publisher: HC Pro, Inc.
ISBN: 1601460694
Size: 67.24 MB
Format: PDF
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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.

The Managed Care Contracting Handbook

Author: Maria K. Todd
Publisher: Irwin Professional Pub
Size: 15.37 MB
Format: PDF, Kindle
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This work provides this information and shows the reader how to: evaluate both payer-proposed and self-authored managed care agreements; position their facility and services to secure and maintain managed care agreements that will yield ...

Risk Management Handbook For Health Care Organizations 3 Volume Set

Author: American Society for Healthcare Risk Management (ASHRM)
Publisher: John Wiley & Sons
ISBN: 0470649194
Size: 47.33 MB
Format: PDF, Kindle
View: 7413
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If a denial of benefits is still issued by the MCO, the physician or provider should
appeal the decision vigorously, if he or she believes that that decision is flawed
and the patient's outcome will be jeopardized. It is ultimately the physician's
responsibility to do the best he or she can to ensure the patient receives
whatever medical care is necessary. Contract Management Healthcare
organizations and providers are faced with exposures that arise from contracts
they enter into with other ...