The Managed Care Contracting Handbook

The Managed Care Contracting Handbook PDF

Author: Maria K. Todd

Publisher: CRC Press

Published: 2009-03-26

Total Pages: 334

ISBN-13: 1439866570

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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 contingencies to cover ... and when to ask a lawyer

Managed Care Contracting

Managed Care Contracting PDF

Author: William A. Garofalo

Publisher: Jossey-Bass

Published: 1999-01-06

Total Pages: 0

ISBN-13: 9780787945817

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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

Managed Care Contracting

Managed Care Contracting PDF

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.

The Managed Care Contracting Handbook

The Managed Care Contracting Handbook PDF

Author: Maria K. Todd

Publisher: CRC Press

Published: 2009-03-26

Total Pages: 211

ISBN-13: 1040081118

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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 contingencies to cover ... and when to ask a lawyer

Top Managed Care Contracting Clauses

Top Managed Care Contracting Clauses PDF

Author: Peter Robert Fisk

Publisher: HC Pro, Inc.

Published: 2007

Total Pages: 158

ISBN-13: 1601460694

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As a provider, your survival hinges on your ability to maximize reimbursements from managed care contracts and control access to agreed-upon discounts. But money lost at the time of service or through the collection process is often determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated. Top Managed Care Contracting Clauses: A Toolkit for Providers contains practical strategies and tools for any organization facing the prospect of negotiating a new managed care contract.

Improving the Medicare Market

Improving the Medicare Market PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1996-11-01

Total Pages: 384

ISBN-13: 0309175364

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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.

Managed Care Contracting

Managed Care Contracting PDF

Author: Douglas A. Conrad

Publisher:

Published: 1996

Total Pages: 156

ISBN-13:

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However, successful managed care contracting is a daunting challenge, requiring a range of skills from creating an organizational vision and strategy to pricing specific services. Managed Care Contracting provides all the necessary tools to meet the challenge of managed care contracting.

Managed Care Contracting

Managed Care Contracting PDF

Author: Reed Tinsley

Publisher: American Medical Association Press

Published: 1999

Total Pages: 132

ISBN-13:

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This book provides thorough guidance on how to successfully negotiate both discounted fee-for-service and capitated managed care contracts and offers strategies designed to improve managed care contracting relationships.