Medicare Managed Care Manual PDF Download
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Author: C. Keith Powell
Publisher:
ISBN:
Category : Medicare
Languages : en
Pages :
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Book Description
Author: C. Keith Powell
Publisher:
ISBN:
Category : Medicare
Languages : en
Pages :
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Book Description
Author: Larry S. Gage
Publisher: Clark Boardman Callaghan
ISBN: 9780876322949
Category : Health care reform
Languages : en
Pages :
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Author:
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 2682
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Book Description
Author: Geraldine Dallek
Publisher: DIANE Publishing
ISBN: 0788170791
Category : Health maintenance organizations
Languages : en
Pages : 85
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Book Description
Based on both research & reports from organizations representing Medicare beneficiaries, this report analyzes the major problems associated with Medicare HMOs & provides recommendations to achieve protection of Medicare beneficiaries. Addresses: marketing, enrollment & disenrollment; Medicare-covered benefits & the HMO appeals process; access to appropriate providers; data collection, analysis & disclosure; quality-of-care, monitoring & oversight; the AAPCC rate, standardization of plan benefits & risk adjustments; & regulation of managed care entities such as provider sponsored organizations.
Author: Wolters Kluwer Law & Business
Publisher: Wolters Kluwer
ISBN: 145486768X
Category : Medical
Languages : en
Pages : 1989
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Book Description
The 2015 Master Medicare Guide is packed with timely and useful information to help you stay on top of one of the most complex programs administered by the federal government. The 2015 Edition includes: Over 500 explanation summaries for all aspects of the Medicare program coverage, eligibility, reimbursement, fraud and abuse, and administration Highlights of the Protecting Access to Medicare Act of 2014 (P.L. 113-93) and the Improving Medicare Post-Acute Care Transformation Act of 2014 (P.L. 113-185)""; the most recent physician fee schedule reimbursement fix; A focus on the continuing implementation of the Affordable Care Act as it relates to Medicare, including accountable care organizations and a tighter link between the quality of health care and Medicare reimbursement All discussions include cross-references to relevant laws, regulations, CMS manual sections, administrative and judicial decisions, and more!
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Publishers
ISBN: 1449649823
Category : Medical
Languages : en
Pages : 295
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Book Description
The new Third Edition of Managed Health Care: What It Is and How It Works is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.
Author: Larry S. Gage
Publisher: Delmar Pub
ISBN: 9780836613049
Category : Medical
Languages : en
Pages :
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Author:
Publisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 308
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Book Description
Author: William N. Tindall
Publisher: Jones & Bartlett Learning
ISBN: 9780834217652
Category : Managed care plans
Languages : en
Pages : 322
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Book Description
Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati
Author: Stein, Chiplin
Publisher: Wolters Kluwer
ISBN: 1543800459
Category :
Languages : en
Pages : 832
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Book Description
To provide effective service in helping people understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2019 Edition of Medicare Handbook offers expert guidance on: Medicare Enrollment and Eligibility Medicare Coverage in all Care-Settings Medicare Coverage for People with Chronic Conditions Medicare Home Health Coverage and Access to Care Prescription Drug Coverage Medicare Advantage Plans Medicare Appeals Health Care Reform And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am enrolled in Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get Medicare for my nursing and therapy services? And more! The 2019 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions when advocacy problems arise, and those areas in which coverage has often been reduced or denied And more! Note: Online subscriptions are for three-month periods. Previous Edition: Medicare Handbook, 2018 Edition ISBN 9781454884224
