A Practical Guide to Reimbursement in Managed Care

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.

Select a format

eBook:epub
ISBN: 9781639053810
In Stock
Price
$89.95
Best value
QTY
eBook:mobi
ISBN: 9781639053810
In Stock
Price
$89.95
Best value
QTY
International Order Inquiry

Product description

View a sample of this title using the ReadNow feature

A Practical Guide to Reimbursement in Managed Care provides historical background on Medicare reimbursement approaches as well as practical information on how commercial payers have adopted (or not adopted) Medicare reimbursement approaches and the challenges they have faced in the process -- both from a contracting strategy standpoint as well as a legal standpoint. Working through Medicare's reimbursement approaches across different types of healthcare providers, from hospitals to physicians and ancillary services, the book traces the origins of each of Medicare reimbursement systems and provides useful details on how the Medicare program calculates rates. It then moves into the commercial health insurance space, describing important concepts related to payer-provider contracting, types of health plans, and payer and provider perspectives on how they approach the contractual relationship.

A Practical Guide to Reimbursement in Managed Care also provides a historical view of contracting both from a provider and payer perspective, layering in historical milestones with practical reasons why the U.S. system has become what it is today. It then concludes with a deep dive into the important legal issues that arise in payer-provider disputes, including contracts, commonly disputed issues and case examples.

eBooks, CDs, downloadable content, and software purchases are noncancelable, nonrefundable and nonreturnable. Click here for more information about LexisNexis eBooks. The eBook versions of this title may feature links to Lexis+® for further legal research options. A valid subscription to Lexis+® is required to access this content.