Last edited by Yozshugal
Wednesday, April 29, 2020 | History

5 edition of Managed care contracting found in the catalog.

Managed care contracting

a practical guide for health care executives

by William A. Garofalo

  • 178 Want to read
  • 33 Currently reading

Published by Jossey-Bass Publishers in San Francisco .
Written in English

    Places:
  • United States.
    • Subjects:
    • Managed care plans (Medical care) -- United States.,
    • Medical care -- Contracting out -- United States.,
    • Managed Care Programs -- organization & administration -- United States.,
    • Contract Services -- organization & administration -- United States.

    • Edition Notes

      Includes index.

      StatementWilliam A. Garofalo, Eve T. Horwitz, Thomas M. Reardon ; foreword by Norman C. Payson.
      ContributionsHorwitz, Eve T., Reardon, Thomas M.
      Classifications
      LC ClassificationsRA413.5.U5 G37 1999
      The Physical Object
      Paginationxvii, 115 p. :
      Number of Pages115
      ID Numbers
      Open LibraryOL381091M
      ISBN 100787945811
      LC Control Number98043360
      OCLC/WorldCa39857645

      Here are 96 questions in 23 categories you should address when considering and reviewing managed care contracts. Definitions. Are the important terms used in the agreement clearly defined? SAMPLE MANAGED CARE CONTRACT The Payer and the Network you are contracting with are not necessarily the same. The Payer may pay the or practice, by any licensure or certification agency, by any reimbursement entity or managed care organization, or by any similar entity or organization, to revoke, suspend, restrict, or otherwise. Get this from a library! Managed care contracting: concepts and applications for the health care executive. [Douglas A Conrad;] -- Managed care contracting has become a core business function in health care. For hospitals, physician groups, and health plans, the ability to create win-win managed care relationships is a.


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Managed care contracting by William A. Garofalo Download PDF EPUB FB2

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We are a complete managed care contracting services’ company for payer contracting, contracts’ analysis, credentialing, claims management, and providers’ marketing needs. Aug 01,  · The book begins with an in-depth discussion of managed care concepts and managed care organizations, Managed care contracting book a chapter on reimbursement methods, and also discusses Tricare and quality issues associated with managed care.

Once familiar with basic managed care concepts, The Managed Care Contracting Handbook offers readers important advice on Book Edition: 1st. He was a chapter author of the Health Plans Contracting Handbook: A Guide for Payors and Providers, sixth edition (, American Health Lawyers Association), a co-author of the Managed Care Contracting chapter of the Health Law Practice Guide (, Thomson West), and a Managed care contracting book co-author of the Representing Physicians Handbook, third edition.

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By contracting with various types of MCOs to deliver Medicaid Managed care contracting book health care Managed care contracting book to their beneficiaries, states can reduce Medicaid program costs and better manage utilization of health services.

Improvement in health plan performance, health care quality, and outcomes are key objectives of Medicaid managed care. The reimbursement rates negotiated with managed care companies in your market are a crucial element to a healthy bottom line. Obtaining and maintaining profitable managed care contracts and managing those contracts on an ongoing basis is the proven method to maximize your patient revenue streams.

Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don’t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what.

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Contracts’ negotiations and analysis are not part of the average healthcare staff member’s training curriculum. Yet, these are critical skills to help boost provider revenues through agreements with payers. That’s where we come in. Mar 24,  · Managed care contracting is a process that frustrates even the best administrators.

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Todd. Understanding managed care contracting --The contract negotiations --Reviewing the provider contract --Analyzing financial arrangements --Exploring issues for group contracting --Specialty care contracting --Ambulatory and ancillary care contracting --Managed prescription drug programs --Dental managed care --Regulation of managed care.

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