JoAnna B. Younts, Steven D. Hamilton, Franklin Stevens, MacKenzie S. Wallace

A Practical Guide to Reimbursement in Managed Care (eBook, ePUB)

• Format: ePub

Produktbeschreibung

This book provides a detailed historical account of Medicare reimbursement and payment approaches used across nearly all provider types, along with a practical discussion of commercial payer contracting and payment strategies. It then concludes with a deep dive into the legal issues that arise in payer-provider disputes, including the most common issues and case examples.

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Produktdetails

• Verlag: American Bar Association
• Seitenzahl: 202
• Erscheinungstermin: 30. Januar 2024
• Englisch
• ISBN-13: 9781639053827
• Artikelnr.: 70383637

Autorenporträt

JoAnna has worked in the healthcare industry for nearly 35 years. Her primary area of expertise is Medicare reimbursement and its relationship to commercial reimbursement. She worked as a contractor for the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) on the development of the Medicare Outpatient Prospective Payment System (OPPS) for hospitals as well as evaluations of the Inpatient Prospective Payment System (IPPS).

JoAnna splits her time between strategic advisory work for payers and providers and payer-provider disputes. In her advisory work, she provides analysis and recommendations regarding reimbursement and contracting, including fee schedule updates, benchmarking and out-of-network policies. In litigation, she serves as a consulting expert on issues relating to billing and coding, reimbursement rates, payment policies and out-of-network issues.