Download or read book The Complete Idiot s Guide to Managed Health Care written by Sophie M. Korczyk and published by . This book was released on 1997-12-11 with total page 326 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed health care is one of the most confusing areas any consumer can deal with. Rules and regulations are constantly changing, providers are always merging and changing their offerings, and paperwork abounds. In easy-to-understand language, this book explains how to understand options, how to get treatment for chronic and long-term illnesses, how to get the most care for the least cost, and more.
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:
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.
Download or read book Managed Care written by Peter Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2009-10-07 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.
Download or read book Breaking Free of Managed Care written by Dana C. Ackley and published by Guilford Press. This book was released on 1999-08-01 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: Providing therapists practical solutions to managed care's erosion of their freedom to practice, this book presents a working blueprint for a private-pay psychotherapy practice. Dana C. Ackley casts out the distortions that have crept into many clinicians' thinking as a result of reliance on third-party reimbursement. Based on his own experience, he shows how you can serve clients--and yourself--better by developing real alternatives to the pressures and bureaucracy of managed care. In clear step-by-step detail, including practical exercises and checklists, sample marketing materials, and payment plans, the volume shows you how to: *Rediscover the economic and clinical value of your work *Discard assumptions that might block your progress *Educate yourself about the needs of potential clients *Market and sell your services effectively *Learn ethical, reasonable business-of-practice skills *Diversify into the rewarding area of psychological consultation to businesses. No matter what your clinical style, theoretical orientation, or practice history, you will benefit from the hard-won lessons Dr. Ackley shares in this book.
Download or read book Community and Nurse Managed Health Centers written by Donna L. Torrisi, MSN and published by Springer Publishing Company. This book was released on 2005-06-03 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! A National Nursing Centers Consortium Guide This book provides a step-by-step guide to starting and sustaining a community health center, with an emphasis on nurse-managed centers. The authors share their firsthand knowledge with readers, including information on developing a mission statement, pulling together an advisory board, writing a business plan, and getting funding. The process for obtaining Federally Qualified Health Center Status (and thus federal funding) is described. Of great value is the bookís Appendix, which provides very useful examples. They include sample bylaws, a full policy and procedure manual, physician and nurse practitioner collaborative agreements, job descriptions, a contract with a local agency, and outcome and assessment guidelines. Donna Torrisi is the founder of The Family Practice and Counseling Network in Philadelphia, which provides primary health services to public housing residents; Tine Hansen-Turton is the Executive Director of the National Nursing Centers Consortium. For Further Information, Please Click Here!
Download or read book Managing Managed Care II written by Michael Goodman and published by American Psychiatric Pub. This book was released on 1996 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition, provides an easy-to-learn, easy-to-use method for documenting and communicating the necessity, appropriateness, and course of treatment for managed care review. Using the Patient Impairment Profile method, practitioners can convincingly convey a clinical rationale for treatment, efficiently track progress over time, and demonstrate favorable patient outcomes. Keeping pace with the evolving and expanding presence of managed care, the authors have extensively revised and enlarged the previous edition. New clinical research on the validity and reliability of the impairment terminology has produced a much-improved, clinically valid, and statistically reliable impairment lexicon. Detailed severity rating qualifiers, reference lists of patient objectives, and a useful glossary have been added. All regulations have also been updated. Managing Managed Care II is reference and valuable resource for mental health practitioners and for the individuals who monitor and review treatment. By providing concise, relevant, and outcome-focused treatment information, practitioners become proactive participants in managed care while adeptly articulating the value and quality of their services.
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.
Download or read book A Guide to Managed Care Medicine written by William N. Tindall and published by Jones & Bartlett Learning. This book was released on 2000 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati
Download or read book Psychodynamic Practice in a Managed Care Environment written by Michael B. Sperling and published by Guilford Press. This book was released on 1999-12-08 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite the constraints and challenges imposed by managed care, many psychodynamic clinicians are finding ways to work successfully within this pervasive type of health care arrangement. This clear, straightforward book shows how. Grounded in the authors' high professional standards and commitment to psychodynamic principles, the book provides the information and guidance that therapists need to communicate effectively with managed care decision makers, maximize the likelihood of obtaining treatment authorization, and adapt to the demands of time-limited treatment. Extensive case material and concrete examples illustrate ways to "translate" case formulations, treatment plans, and reports into an alternative functional language more readily accepted by managed care, without compromising the psychodynamic conceptual framework. A range of brief dynamic therapy models and techniques are described, and their implications for managed care practice are explored. Clinicians also learn how to present an empirically based rationale and appropriate documentation for their services; select and make use of treatment outcome measures; and deal with clinical and ethical dilemmas that are likely to arise. Useful appendices list additional resources for clinicians and include a glossary of health care and health insurance terminology.
Download or read book Improving the Medicare Market written by Institute of Medicine and published by National Academies Press. This book was released on 1996-11-01 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.
Download or read book Managed Care Contracting written by William A. Garofalo and published by Jossey-Bass. This book was released on 1999-01-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Today's heath care marketplace is highly competitive, requiring managed care providers to contract with dozens of insurers to survive. Each of these contracts comes with their its unique terms and conditions-making the contracting process overwhelmingly complex and giving many health care executives major headaches. Written by three of the country's leading health care consultants and attorneys, Managed Care Contracting is the first book to offer executives with no legal background practical, step-by-step advice on how to create winning contracts between health care organizations, payers, and employers. In straightforward language, free of legalese and jargon, this much-needed resource demystifies managed care contracting and prescribes some critical advice for hospital and physician group practice executives. The authors present helpful guidelines for evaluating the various types of managed care contracts and explain the most significant terms and concepts executives are likely to encounter. A treasure trove of information for health care executives no matter what their experience level, Managed Care Contracting Examines how to develop a contracting strategy Reviews the fundamentals of negotiating the contract Frames the key steps in the contracting process Provides a managed care contract negotiations checklist Dissects sample hospital and physician contracts Analyzes the contract risk factors by the type of payment explores the implications of changing financial incentives Outlines the most up-to-date information in the regulatory environment Includes illustrative examples and helpful tables and chartsFor health care executives who are just beginning the complex contracting process and for the more experienced who require the most current information on the topic, Managed Care Contracting provides the knowledge and tools they need to succeed. "Managed Care Contracting is a very timely
Download or read book Harvard Medical School Family Health Guide written by Harvard Medical School and published by Simon and Schuster. This book was released on 2005 with total page 1316 pages. Available in PDF, EPUB and Kindle. Book excerpt: An accessible guide to family health care discusses drug interactions, symptoms, first aid, and how to choose a family doctor, including a new research about hormone therapy and heart surgery.
Download or read book Making Them Pay written by Rhonda D. Orin and published by Macmillan + ORM. This book was released on 2011-04-01 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most people don't understand health insurance, and insurance companies know it. Unfair denials, late payments, and hopeless confusion are the norm. At last there is a solution. In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy. Like: -Figuring out what health plans really say -Understanding what benefits they provide -Finding, and understanding, the exclusions -Determining what health plans really cost -How to talk to customer service, and other painful details -Easy ways to keep good records -Laws that can change your life-like the mandatory benefits laws in all fifty states -How to prepare successful appeals Along with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars, and vignettes that will make you laugh as you learn. Based on Rhonda D. Orin's extensive experience as a litigator, a journalist, and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read. "A compact reference [that] simplifies a convoluted subject. -
Download or read book Medicine and Business written by Ronald V. Bucci and published by Springer Science & Business Media. This book was released on 2014-03-18 with total page 199 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is designed to provide physicians with the information they need in applying business management skills to their medical practice. It covers management and leadership practices, financial planning and execution, hospital governance, managed care, marketing activities, and medical business law. Written for the physician in easily understandable language, it describes each concept, delineates its applications in various practice environments and provides insight into the future developments in each sector.
Download or read book Regulating Managed Care written by Stuart H. Altman and published by Jossey-Bass. This book was released on 1999-06-25 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital
Download or read book Basics of the U S Health Care System written by Niles and published by Jones & Bartlett Learning. This book was released on 2016-12-14 with total page 449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Basics of the U.S. Health Care System, Third Edition provides students with a broad, fundamental introduction to the workings of the healthcare industry. Engaging and activities-oriented, the text offers an especially accessible overview of the major concepts of healthcare operations, the role of government, public and private financing, as well as ethical and legal issues. Each chapter features review exercises and Web resources that make studying this complex industry both enjoyable and easy. Students of various disciplines—including healthcare administration, business, nursing, public health, and others—will discover a practical guide that prepares them for professional opportunities in this rapidly growing sector.
