Managed Care Contracting

Managed Care Contracting

Author: Wendy Knight

Publisher:

Published: 1997

Total Pages: 392

ISBN-13:

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This book provides physician executives and medical group managers with a 'next generation' reference on the managed care contracting process. This handbook will educate health care providers about managed care contracting: how the contracting process works, what a standard practice contract looks like and why certain provisions are included, what questions to ask and how to evaluate a capitation rate. Provides pertinent information from professionals in the field.


PPOs

PPOs

Author: Samuel J. Tibbitts

Publisher:

Published: 1984

Total Pages: 304

ISBN-13:

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The New Healthcare Market

The New Healthcare Market

Author: Peter Boland

Publisher: Aspen Publishers

Published: 1985

Total Pages: 1148

ISBN-13:

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This industry classic gives the perspectives of 107 distinguished expertsfrom the health care industry as well as the financial and legal worldswho evaluate the benefits and disadvantages of competitive health care practices and analyze the significance of PPOs to providers, payors, and purchasers. Their practical experience and breadth of knowledge offer a wealth of pragmatic advice about taking advantage of the changing market.


The Physician Employment Contract Handbook, Second Edition:

The Physician Employment Contract Handbook, Second Edition:

Author: Maria K. Todd

Publisher: CRC Press

Published: 2011-06-30

Total Pages: 210

ISBN-13: 1439813175

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No matter which way you look at it, whether you own your own practice, become a part of a large physician group, or become an employee of a hospital, you will be signing an employment contract of some sort. Revised and updated, The Physician Employment Contract Handbook, Second Edition: A Guide to Structuring Equitable Arrangements provides sample physician employment contracts and explains how each contract works. The new edition includes increased information on the latest managed care entities and a review of basic concepts in fraud and abuse, corporate practice of medicine, and antitrust concerns. The author discusses the various legal and compliance issues related to physician employment, such as anti-self referral and anti-kickback issues, and examines how to resolve disputes through arbitration or mediation. The author also outlines the pros and cons of various partnership arrangements. After you have finished this book, you will be able to ask meaningful questions of legal and accounting counsel, do a preliminary review and analysis of the agreement offered, and even compare a prospective employer’s contract to other standard agreements without endangering confidentiality agreements. You will be able to design standard text, saving time and money on legal fees by having counsel review and add the final touches to contract drafts instead of starting from scratch. With proper planning and a clear understanding of both short- and long-term objectives, you can move into the future and take advantage of opportunities in the current healthcare revolution.


AHLA Health Plans Contracting Handbook (AHLA Members)

AHLA Health Plans Contracting Handbook (AHLA Members)

Author:

Publisher:

Published: 2016

Total Pages:

ISBN-13: 9781632805416

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The Health Plans Contracting Handbook, Seventh Edition from AHLA traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues. It identifies key questions typically encountered in preparing such agreements with a perspective that incorporates the current environmental challenges confronting managed care organizations, including the impact that healthcare reform issues will have on Provider-Payer relations. The Handbook considers the interests of Payers alongside those of providers and juxtaposes sample Provider-Friendly and Payer-Friendly language in order to help frame the negotiation and documentation of the parties' competing interests. It also offers separate chapters on Medicare and Medicaid managed care contracting in recognition of the growing significance that governmental Payers will have in years to come. Each chapter finishes with a bullet-point checklist of key considerations and a list of other useful resources, including both print and web-based sources.The eBook versions of this title feature links to Lexis Advance for further legal research options.


Physician's Managed Care Success Manual

Physician's Managed Care Success Manual

Author: Scott Becker

Publisher:

Published: 1999

Total Pages: 420

ISBN-13:

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Broad changes in the methods of paying for health care services have led to vast changes in the practice of medicine. This book provides the basic tools, including checklists, sample contracts, and key terms a physician needs to take charge of his or her future in the evolving health care system. It explains models and concepts that are available from market to market. More important, this book provides numerous tested strategies for responding to opportunities and the basic principles and means by which to judge situations and proposals. It will guide today's physicians through the managed care maze as they develop business plans and negotiate contracts. * Helps you take and maintain control over patient care by maximizing your autonomy. * Outlines differences in practice type and summarizes the pros and cons of your various options within the managed care environment. * Uses real-life examples throughout, discussing both successes and failures of other entrepreneurial physicians.