Maria Todd

The Managed Care Contracting Handbook (eBook, ePUB)

Planning & Negotiating the Managed Care Relationship

• Format: ePub

Produktbeschreibung

Demystifying the contracting process, the second edition of this unique work is an essential how to book for those venders involved with the delivery of managed care services. Easy to read and concise this edition provides an updated look at this rapidly evolving area. It offers an in-depth look at managed care and its organizations as a foundation for contracting strategies and covers key issues such as consumer driven health plans, pay for performance initiatives, and contract negotiations. Written by seasoned professional in managed care contracting, it also offers a comprehensive layman's evaluation of a typical managed care agreement, as well as sample contracts and important checklists.

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Produktdetails

• Verlag: Taylor & Francis
• Erscheinungstermin: 26. März 2009
• Englisch
• ISBN-13: 9781040081112
• Artikelnr.: 69996360

Autorenporträt

Maria K. Todd, PhD, MHA is a professional consultant providing the wealth of her knowledge and practical wisdom to more than 2000 hospitals, physicians, and therapists during the past 25 years. Possessing a depth and diversity of experience matched by few, she has earned a reputation as a peerless expert on managed care. She worked as an EMT and a surgical tech before moving into medical administration and health plan coordination. In addition to degrees in health administration, she is a certified mediator and health law paralegal. A prolific author, she is in constant demand as an award-winning speaker. As a volunteer, she has directly assisted hundreds of senior citizens.

Inhaltsangabe

What Is Managed Care? Managed Care Organizations. All-Products Contracts.
Dealing with Self-Funded ERISA Payers in Managed Care: Employee Retirement
Income Security Act (ERISA) of 1974. Medicaid Managed Care. Consumer Driven
Health Plans: Contracting Implications. Silent Preferred Provider
Organizations (PPOs), Secondary Markets, and White Space Management: Three
Terms That Translate to Revenue Erosion and Frustration. Single-Case and
Continuous-Discount Arrangements. Quality Issues in Managed Care (Pay for
Performance). Reimbursement Methods in Managed Care. Strategic Planning for
Renewals and New Contracts:Understanding the Changing Competitive
Environment. Developing Business Rules for Better Contracts. Negotiation
Techniques, Tactics, and Strategies. Contract Law Basics. Evaluating a
Managed Care Agreement-Step-by-Step. Appendix. Insurance and Managed Care
Glossary.