Cargando…
Health Plans Unmasked : A Physician's Guide to Working with Health Insurers /
"This book is written for leaders of provider organizations as a strategic guide to value-based contracting with health plans. In this book the author describes why insurance companies do the things they do, in order to help show ways to approach them efficiently and successfully. The book also...
| Autor principal: | |
|---|---|
| Formato: | Electrónico eBook |
| Idioma: | Inglés |
| Publicado: |
Baltimore :
Johns Hopkins University Press,
2023.
|
| Colección: | Book collections on Project MUSE.
|
| Temas: | |
| Acceso en línea: | Texto completo |
Tabla de Contenidos:
- Historical context
- What is a health plan?
- Medicare
- Medicaid
- Commercial insurance
- Brokers and consultants
- The ABCs of fee-for-service
- What happens to a claim
- Payment errors
- Health plan strategic concerns
- Analytics
- Cost management strategies
- Quality
- Care management
- Health plan committees
- Health plan contracting 101
- Value-based budgeting
- Incentive payments
- Risk mitigation
- Price transparency
- Subrogation
- Pharmacy benefit management
- On becoming a payvider
- Closing thoughts.