Download or read book Improve Payment Practices of Employee Organization Health Plans written by United States. Congress. House. Committee on Post Office and Civil Service. Subcommittee on Compensation and Employee Benefits and published by . This book was released on 1980 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Stronger Management Needed to Improve Employee Organization Health Plans Payment Practices written by United States Accounting Office (GAO) and published by Createspace Independent Publishing Platform. This book was released on 2018-06-26 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stronger Management Needed To Improve Employee Organization Health Plans' Payment Practices
Download or read book Improve Payment Practices of Employee Organization Health Plans written by United States. Congress. House. Committee on Post Office and Civil Service. Subcommittee on Compensation and Employee Benefits and published by . This book was released on 1980 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Stronger management needed to improve employee organization health plans payment practices written by United States. General Accounting Office and published by . This book was released on 1979 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Office of Personnel Management (OPM) has not done an effective job of guiding and overseeing the Employee Organization Plans participating in the Federal Employees Health Benefits program. OPM has allowed the plans to make claim payments without determining whether the claims represented sound comprehensive systems to determine the reasonableness of charges as the contracts require. The Plans have paid claims without having information necessary to demonstrate medical necessity. Paid claims were found that: (1) appeared to represent noncovered routine physical examinations; (2) had been paid with no indication of symptoms or diagnoses; (3) had diagnoses or symptoms that were not clearly related to the tests provided; (4) were for hospitalizations that appeared either unnecessary or too long; and (5) were paid as emergencies when the patients' diagnoses did not indicate emergencies. The Plans' payment system did not fully comply with the contracts. The Plans are required to develop reasonable charge allowances and pay only up to those amounts except in unusual circumstances. OPM has been aware of some of these problems, but it has provided little formal guidance to help the plans determine medical necessity or reasonable allowances.
Download or read book Employment written by U S Government Accountability Office (G and published by BiblioGov. This book was released on 2013-06 with total page 78 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Office of Personnel Management (OPM) has not done an effective job of guiding and overseeing the Employee Organization Plans participating in the Federal Employees Health Benefits program. OPM has allowed the plans to make claim payments without determining whether the claims represented sound comprehensive systems to determine the reasonableness of charges as the contracts require. The Plans have paid claims without having information necessary to demonstrate medical necessity. Paid claims were found that: (1) appeared to represent noncovered routine physical examinations; (2) had been paid with no indication of symptoms or diagnoses; (3) had diagnoses or symptoms that were not clearly related to the tests provided; (4) were for hospitalizations that appeared either unnecessary or too long; and (5) were paid as emergencies when the patients' diagnoses did not indicate emergencies. The Plans' payment system did not fully comply with the contracts. The Plans are required to develop reasonable charge allowances and pay only up to those amounts except in unusual circumstances. OPM has been aware of some of these problems, but it has provided little formal guidance to help the plans determine medical necessity or reasonable allowances.
Download or read book Improve Payment Practices of Employee Organization Health Plans written by United States. Congress. House. Committee on Post Office and Civil Service. Subcommittee on Compensation and Employee Benefits and published by . This book was released on 1980 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Legislative Review of the Committee on Post Office and Civil Service House of Representatives During the Ninety sixth Congress First Session written by United States. Congress. House. Committee on Post Office and Civil Service and published by . This book was released on 1980 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book GAO Documents written by United States. General Accounting Office and published by . This book was released on with total page 806 pages. Available in PDF, EPUB and Kindle. Book excerpt: Catalog of reports, decisions and opinions, testimonies and speeches.
Download or read book Health bibliography written by and published by . This book was released on 1981 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-08-19 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book Personnel Literature written by United States. Office of Personnel Management. Library and published by . This book was released on 1981 with total page 726 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book OPM Should Promote Medical Necessity Programs for Federal Employees Health Insurance written by United States. General Accounting Office and published by . This book was released on 1980 with total page 82 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Monthly Catalogue United States Public Documents written by and published by . This book was released on 1981 with total page 876 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Monthly Catalog of United States Government Publications written by and published by . This book was released on 1980 with total page 1228 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Future of Nursing 2020 2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Download or read book Monthly List of GAO Reports written by and published by . This book was released on 1979 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt: Includes legal decisions and opinions of the Comptroller General.
Download or read book Monthly Catalog of United States Government Publications written by United States. Superintendent of Documents and published by . This book was released on 1968 with total page 1220 pages. Available in PDF, EPUB and Kindle. Book excerpt:
