Credentialing In The Managed Care Environment
DOWNLOAD
Download Credentialing In The Managed Care Environment PDF/ePub or read online books in Mobi eBooks. Click Download or Read Online button to get Credentialing In The Managed Care Environment book now. This website allows unlimited access to, at the time of writing, more than 1.5 million titles, including hundreds of thousands of titles in various foreign languages. If the content not found or just blank you must refresh this page
Credentialing In The Managed Care Environment
DOWNLOAD
Author : Hugh P. Greeley
language : en
Publisher:
Release Date : 1996
Credentialing In The Managed Care Environment written by Hugh P. Greeley and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996 with Hospitals categories.
Credentialing For Managed Care
DOWNLOAD
Author : Amy M. Niehaus
language : en
Publisher:
Release Date : 2016-08-17
Credentialing For Managed Care written by Amy M. Niehaus and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-08-17 with categories.
Credentialing for Managed Care: Compliant Processes for Health Plan and Delegated Entities Amy M. Niehaus, CPMSM, CPCS, MBA New to managed care credentialing? Whether you work for a health plan or a hospital medical staff services department, this how-to guide answers all of your health plan credentialing and enrollment questions. Learn the regulatory and accreditation requirements related to managed care credentialing, including those from CMS, NCQA, and URAC. Author Amy M. Niehaus, CPMSM, CPCS, MBA, provides readers with the guidance to create a comprehensive and compliant credentialing program to support your health plan or to streamline your hospital's provider enrollment process through delegation. MSPs in all healthcare environments can benefit from understanding credentialing in the managed care world to support their organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction. This book will help you: - Understand NCQA, URAC, and CMS requirements for health plans - Develop a comprehensive and compliant managed care credentialing program - Establish delegated credentialing agreements - Audit credentials files - Recognize how payer credentialing requirements impact other healthcare organizations - Streamline provider enrollment through delegation - Identify the differences between hospital and managed care credentialing - Evaluate whether a credentials verification organization is right for your organization About the author: Amy M. Niehaus, CPMSM, CPCS, MBA, is a consultant with The Greeley Company, an industry-leading healthcare consulting firm. She has over 25 years' experience in the medical services and credentialing profession. In her current role, she advises clients in the areas of accreditation, regulatory compliance, credentialing, process simplification and redesign, credentialing technology, and credentials verification organizations (CVO) development and delegation. Niehaus has worked in multiple environments throughout her career, including acute care hospitals, CVOs, and managed care organizations (MCO). She has been a member of the National Association Medical Staff Services (NAMSS) since 1991 and achieved her CPMSM certification in 1992 and her CPCS certification in 2002. Niehaus is a NAMSS instructor and previously served as chair of its MCO Task Force, as well as chair and member of the NAMSS Education Committee. She is a former president of the Missouri Association Medical Staff Services and its greater St. Louis area chapter. Niehaus holds a bachelor's degree from the University of Missouri and a master's degree in business administration from Maryville University in St. Louis. Niehaus has developed and presented various programs to local and national audiences on topics such as credentialing and privileging processes; Joint Commission, National Committee for Quality Assurance (NCQA), and URAC accreditation standards; and delegation.
Managed Care Credentialing
DOWNLOAD
Author : Amy N. Niehaus
language : en
Publisher:
Release Date : 2019
Managed Care Credentialing written by Amy N. Niehaus and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with Managed care plans (Medical care) categories.
The role of the MSP is expanding to include payer enrollment and delegated credentialing responsibilities for managed care organizations. Traditionally siloed, MSPs are now beginning to take on both responsibilities, which means they must learn the nuances of managed care credentialing as well as the regulatory and accreditation requirements of NCQA, CMS, and URAC. Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs, and Delegated Entities provides the answers to MSPs' inevitable questions as they begin to manage the tasks of payer enrollment and delegated credentialing. Author Amy M. Niehaus guides readers through each payer's requirements, the differences between hospital and managed care credentialing, and how to help their organization establish delegated credentialing agreements and prepare for audits. As new and existing MSP responsibilities begin to collide, this resource also outlines ways MSPs can modify their current processes to reduce duplication of efforts and develop a comprehensive and compliant managed care credentialing program. Whether you are new to managed care credentialing or are taking on delegated credentialing responsibilities, this book will help you: Learn the regulatory and accreditation requirements related to managed care credentialing Streamline the provider enrollment process through delegation Meet your organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction Identify the differences between hospital and managed care credentialing
The Credentialing Handbook
DOWNLOAD
Author : Sheryl Deutsch
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1999
The Credentialing Handbook written by Sheryl Deutsch and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Allied health personnel categories.
The Credentialing Handbook provides comprehensive, plain-English guida nce to understand and master the provider credentialing process in any health care setting. With sample forms, checklists, flowcharts, and c orrespondence, this practical guide walks you through every aspect of effective credentialing, appointment, and recredentialing. You'll lear n: key steps in the credentialing process; about express credentialin g models; how to credential allied health practitioners; typical time frames and tracking systems; pros and cons of delegating credentialin g, plus more.
The Managed Care Handbook
DOWNLOAD
Author : James R. Lyle
language : en
Publisher:
Release Date : 1996
The Managed Care Handbook written by James R. Lyle and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996 with Managed care plans (Medical care) categories.
Critical Concepts In Medical Practice Management
DOWNLOAD
Author : Robert Tallon
language : en
Publisher: Practice Management Information Corporation
Release Date : 1996
Critical Concepts In Medical Practice Management written by Robert Tallon and has been published by Practice Management Information Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996 with Medical categories.
Managed Care Strategies
DOWNLOAD
Author : George B. Moseley
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1999
Managed Care Strategies written by George B. Moseley and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Group medical practice categories.
This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.
Survival Strategies For Nurses In Managed Care
DOWNLOAD
Author : Toni G. Cesta
language : en
Publisher:
Release Date : 2002
Survival Strategies For Nurses In Managed Care written by Toni G. Cesta and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002 with Medical categories.
This book helps nurse managers define their role in the managed care system, learn strategies in financial management and focus on preventative care, while working on re-engineering patient care delivery systems, utilization, and outcomes management. It addresses topics from defining managed care andexplaining how a company works, to addressing ethical and legal issues that arise in the managed care system.
Understanding Managed Care
DOWNLOAD
Author : Thomas N. Wise
language : en
Publisher:
Release Date : 1999
Understanding Managed Care written by Thomas N. Wise and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.
Physicians and allied health care professionals are graduating with in-depth knowledge of disease states and therapeutics, but little, if any practical knowledge of managed care systems. Nevertheless, managed care is so prevalent that in 1998 85% of the US working population was in some form of managed care network and one third of the physicians in practice were enrolled in managed care panels. There are few structured educational opportunities for individuals who are entering health care fields that help in understanding the different managed care systems. Instead, the managed care environment confronts the new physician with an unknown language, a novel management structure, and an expanding scope of rules and regulations. This book is designed to rectify this situation and to serve as a resource for teaching or independent self-paced study. It provides a historical overview, basic structure and components of managed care organizations, and future challenges. A unique series of cases based on a fictional family selecting and using a health plan is presented and a glossary is provided which defines basic concepts frequently encountered in the managed care field.
Managed Care Success
DOWNLOAD
Author : James W. Saxton
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1998
Managed Care Success written by James W. Saxton and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1998 with Liability, Legal categories.
The number of malpractice claims And The severity of final judgments could explode under managed care. Physicians and managed care organizations are on a collision course with malpractice when patient expectations are at an all-time high, and pressures of efficiency are constantly increasing. Defensive medicine -- doing procedures or additional tests, To protect the provider will no longer work. Utilization controls will penalize you, and ultimately, limit your practice. So what's the solution? to be successful in this evolving health care environment, you've got to change with it. You've got to be informed, be prepared, and ready to coexist with it. That's precisely why you need Managed Care Success: Reducing Risk While Increasing Patient Satisfaction . You'll learn how to work with -- not against -- managed care.