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Author: Rachelle A. Dorfman
Publisher: Psychology Press
Published: 1994
Total Pages: 188
ISBN-13: 9780876307083
DOWNLOAD EBOOKFirst Published in 1994. Routledge is an imprint of Taylor & Francis, an informa company.
Author: William L. Poynter
Publisher: Routledge
Published: 2013-10-28
Total Pages: 185
ISBN-13: 1135063850
DOWNLOAD EBOOKFirst published in 1994. A revolution has been taking place in behavioral health financing, and only those practitioners who know how to successfully market themselves to managed care organizations are likely to maintain their hold in this rapidly changing system. Realistic, clear, insightful and highly practical, The Preferred Provider's Handbook will help therapists to understand the managed care marketplace and to develop the strategies necessary to meet its many challenges. You will learn how to: Get accepted on preferred provider lists of managed care organizations (M.C.O.s); Generate patient referrals once you are accepted onto a panel of preferred providers; Retain active referral status over the long term; Zero in on the higher quality networks that produce higher income and have minimal legal risk; Break into closed provider lists-one of the most difficult but important tasks. The Handbook clearly sets forth the basics of managed care with the aim of helping psycho therapists gain an understanding and acceptance of this new system. The volume addresses strategic marketing, whereby therapists can select and pursue those managed care organizations best suited to their needs; provides tools for designing and implementing a marketing plan; and gives a framework for understanding and making profitable use of future trends-in a profes sional and ethical manner. Of particular value is a chapter discussing marketing implications for behavioral health arising from the Clinton administration's new "managed competition" plans. Armed with specific information on how to fill out an M.C.O. application, how to analyze a contract, which specialties are most desirable and which should be avoided, how to network, and much, much more, you will be well on your way to professional success. This is an essential resource for all practitioners in the managed care marketplace.
Author: Hospital Council of Southern California
Publisher:
Published: 1983
Total Pages: 374
ISBN-13:
DOWNLOAD EBOOKAuthor: Ellis Knight
Publisher:
Published: 2016-04
Total Pages: 50
ISBN-13: 9780997284768
DOWNLOAD EBOOKThis handbook enables your organization to systemize the tedious, ongoing, and mandatory process of credentialing your medical staff and to understand why you must! Healthcare organizations must have credentialed medical staffs to deliver their services. The reasons are two-fold: First, educated, licensed, experienced, and proven caregivers ensure that a hospital or medical practice is capable of delivering quality care. Secondly, payers require that the physicians and other licensed healthcare professionals are qualified and licensed to work with their patients. Before receiving payment for services, the provider must have specific credentials for providing that service. Verifying and documenting the credentials of a healthcare provider is tedious, ongoing, and mandatory. An organization with a large medical staff may struggle with keeping the credentialing function current, as many licenses have rolling expirations. Credentialing ensures that clinical practitioners are duly qualified, licensed, and board certified. It reports the history of malpractice claims, state-instituted sanctions, or other undesirable professional circumstances of providers. Credentialing and privileging of healthcare professionals protects patients and hospitals by minimizing the risk of medical errors that may result from the work of incompetent providers. It also undergirds the reputation and credibility of the institution in the eyes of providers and across the healthcare community. Further, credentialing with insurers forms the basis for reimbursement for professional services. Without the acceptance of the professional credentials of a provider, insurers and other third-party payers will not compensate his or her claims. The purpose of this book is to explain the necessity and to provide the process for the official documentation of each practitioner. The information presented in these chapters will serve as a practical resource for strengthening your organization's credentialing function. = Book Features! -Outlines the necessity for credentialing in the delivery of care and in attaining reimbursements for services provided -Explores options for in-house and outsourced credentialing function -Provides systematic process for ongoing credentialing operations
Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
Published: 2001
Total Pages: 1448
ISBN-13: 9780834217263
DOWNLOAD EBOOKThis thoroughly revised and updated book provides a strategic and operational resource for use in planning and decision-making. The Handbook enables readers to fine-tune operation strategies by providing updates on critical managed care issues, insights to the complex managed care environment, and methods to gain and maintain cost-efficient, high quality health services. With 30 new chapters, it includes advice from managers in the field on how to succeed in every aspect of managed care including: quality management, claims and benefits administration, and managing patient demand. The Handbook is considered to be the standard resource for the managed care industry.
Author: American Heart Association
Publisher:
Published: 2020-10-21
Total Pages:
ISBN-13: 9781616697693
DOWNLOAD EBOOKHas companion: BLS basic life support provider manual.
Author: Shawn Hersevoort
Publisher: Lippincott Williams & Wilkins
Published: 2018-10-22
Total Pages: 47
ISBN-13: 1975136160
DOWNLOAD EBOOKPublisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. Written by a psychiatrist who works full-time in the primary care setting, Primary Care Psychiatry Handbook is a quick, practical guide to the key diagnostic and therapeutic information you need to offer optimal mental health care to your patients. Derived from Primary Care Psychiatry, 2nd Edition, this high-yield, point of care handbook uses quick-reference tables, key points, and more to help you answer the question, “What do I do right now?”
Author: Stein, Chiplin
Publisher: Wolters Kluwer
Published: 2016-12-15
Total Pages: 1008
ISBN-13: 1454871172
DOWNLOAD EBOOKTo provide effective service in helping clients understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, Inc., it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2017 Edition of Medicare Handbook offers expert guidance on: Health Care Reform Prescription Drug Coverage Enrollment and Eligibility Medigap Coverage Medicare Secondary Payer Issues Grievance and Appeals Home Health Care Managed Care Plans Hospice Care And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am on Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get nursing and therapy services for my chronic condition? And more! The 2017 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions where advocacy problems arise, and those areas in which coverage has been reduced or denied And more!
Author: Stein, Chiplin
Publisher: Wolters Kluwer
Published: 2018-12-26
Total Pages: 832
ISBN-13: 1543800459
DOWNLOAD EBOOKTo provide effective service in helping people understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2019 Edition of Medicare Handbook offers expert guidance on: Medicare Enrollment and Eligibility Medicare Coverage in all Care-Settings Medicare Coverage for People with Chronic Conditions Medicare Home Health Coverage and Access to Care Prescription Drug Coverage Medicare Advantage Plans Medicare Appeals Health Care Reform And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am enrolled in Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get Medicare for my nursing and therapy services? And more! The 2019 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions when advocacy problems arise, and those areas in which coverage has often been reduced or denied And more! Note: Online subscriptions are for three-month periods. Previous Edition: Medicare Handbook, 2018 Edition ISBN 9781454884224
