| Description |
1 online resource (334 pages) |
| Contents |
Front Cover; Contents; Acknowledgments; Introduction; Chapter 1: What Is Managed Care?; Chapter 2: Managed Care Organizations; Chapter 3: All-Products Contracts; Chapter 4: Dealing with Self-Funded ERISA Payers in Managed Care: Employee Retirement Income Security Act (ERISA) of 1974; Chapter 5: Medicaid Managed Care; Chapter 6: Consumer Driven Health Plans: Contracting Implications; Chapter 7: Silent Preferred Provider Organizations (PPOs), Secondary Markets, and White Space Management: Three Terms That Translate to Revenue Erosion and Frustration |
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Chapter 8: Single-Case and Continuous-Discount ArrangementsChapter 9: Quality Issues in Managed Care (Pay for Performance); Chapter 10: Reimbursement Methods in Managed Care; Chapter 11: Strategic Planning for Renewals and New Contracts: Understanding the Changing Competitive Environment; Chapter 12: Developing Business Rules for Better Contracts; Chapter 13: Negotiation Techniques, Tactics, and Strategies; Chapter 14: Contract Law Basics; Chapter 15: Evaluating a Managed Care Agreement- Step-by-Step; Appendix: Insurance and Managed Care Glossary; Back Cover |
| Summary |
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 for help. Decode and analyze reimbursement problems, loopholes, and contract stipulations you are likely to encounterLearn tried-and-true tricks, tools, shortcuts, and techniques to evaluate agreements Negotiate contracts that won't leave you open to |
| Notes |
Print version record |
| Subject |
Managed care plans (Medical care) -- United States -- Handbooks, manuals, etc
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Negotiation in business -- United States -- Handbooks, manuals, etc
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Managed care plans (Medical care)
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Contracts.
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Managed Care Programs
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Contracts
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Negotiating
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contracts.
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POLITICAL SCIENCE -- Public Policy -- Social Security.
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POLITICAL SCIENCE -- Public Policy -- Social Services & Welfare.
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Contracts
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Managed care plans (Medical care)
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Negotiation in business
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| SUBJECT |
United States https://id.nlm.nih.gov/mesh/D014481 |
| Subject |
United States
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| Genre/Form |
Electronic books
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handbooks.
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Handbooks and manuals
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Handbooks and manuals.
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Guides et manuels.
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| Form |
Electronic book
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| ISBN |
9781439866573 |
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1439866570 |
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