A Practical Guide to Reimbursement in Managed Care / JoAnna B. Younts [and three others].

Format:

Book

Author/Creator:

Younts, JoAnna B., author.

Language:

English

Subjects (All):

Managed care plans (Medical care)--Law and legislation--United States.

Managed care plans (Medical care).

Medicare--Law and legislation.

Medicare.

Capitation fees (Medical care)--United States.

Capitation fees (Medical care).

Physical Description:

1 online resource (215 pages)

Edition:

First edition.

Place of Publication:

Chicago, Illinois : American Bar Association, [2023]

Summary:

"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"-- Provided by publisher.

Contents:

History of government healthcare programs and Medicare hospital reimbursement methods / JoAnna Younts

Medicare reimbursement of physicians and other types of providers / JoAnna Younts

Commercial health insurance plans and networks / JoAnna Younts

Commercial payer contracting and reimbursement / JoAnna Younts

Contracting, reimbursement, and compliance : health plan perspective / Frank Stevens

Contracting, reimbursement, and compliance : provider perspective / Frank Stevens

Setting the stage for payer-provider disputes / Steven Hamilton

Payer-provider disputes from the payer perspective / Steven Hamilton

Payer-provider disputes from the provider perspective / Mackenzie Wallace.

Notes:

Description based on publisher supplied metadata and other sources.

Description based on print version record.

Includes index.

ISBN:

9781639053827

1639053824

OCLC:

1430659160