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Solving the claims conundrum. 解决索赔难题。
Managed care quarterly Pub Date : 2002-01-01
Mary Anne Smith-Shoemake
{"title":"Solving the claims conundrum.","authors":"Mary Anne Smith-Shoemake","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Healthcare providers are being pushed to provide better service, yet maintain costs; and one of those costs is claims processing. There are many hurdles providers must jump over in the transition from capitation to \"fee for service\" billing structures, as well as potential issues surrounding new claim payment timeliness legislation. This article presents some possible solutions for making the claims process more efficient.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 4","pages":"13-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22224097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How well can your members read your online privacy policy? 你的会员能在多大程度上阅读你的在线隐私政策?
Managed care quarterly Pub Date : 2002-01-01
Mark Hochhauser
{"title":"How well can your members read your online privacy policy?","authors":"Mark Hochhauser","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 3","pages":"55-6"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22150905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Information therapy answers the Institute of Medicine's harsh report. 信息疗法回应了医学研究所的严厉报告。
Managed care quarterly Pub Date : 2002-01-01
Steven Schneider
{"title":"Information therapy answers the Institute of Medicine's harsh report.","authors":"Steven Schneider","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Information therapy is the prescription of specific information to a specific person at a specific time to help with a health decision. Correctly prescribed, information becomes medicine--powerful medicine. Information therapy can be as important to a patient's health as any drug, medical test, or surgery. Physicians value the information and advice they give to patients as their most important service, yet the way they perform that service hasn't changed for a hundred years. Doctors still rely chiefly on their clinical experience, their memory, and the spoken word to convey essential information to patients. When patients misunderstand, ignore, or forget the information, this vital service is wasted.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25164992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving medical students' knowledge of systems-based practice. 提高医学生的系统实践知识。
Managed care quarterly Pub Date : 2002-01-01
John M Boltri, Robert L Vogel, William N Tindall, Stuart H Tedders
{"title":"Improving medical students' knowledge of systems-based practice.","authors":"John M Boltri,&nbsp;Robert L Vogel,&nbsp;William N Tindall,&nbsp;Stuart H Tedders","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systems-based practice is an important aspect of medical education. This study evaluates the effectiveness of an eight-hour intervention on medical students' knowledge of the principles of managed care. A pre-test on basic managed care principles was administered to freshman medical students at Mercer University. After an eight- hour managed care curriculum was presented to these students, a post-test was administered. The pre-test and post-test scores on the material increased a mean score of 9.7 points (p < 0.001). Our conclusion is that providing as little as eight-hours of instruction on managed care topics can significantly improve first-year medical students' knowledge and understanding of systems-based practice.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24876126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regulatory oversight of case management services and other medical management functions. 对病例管理服务和其他医疗管理职能进行监管监督。
Managed care quarterly Pub Date : 2002-01-01
Garry Carneal
{"title":"Regulatory oversight of case management services and other medical management functions.","authors":"Garry Carneal","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 4","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22224103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case management redesign in a managed care system: one company's experience. 在管理式医疗系统中重新设计病例管理:一家公司的经验。
Managed care quarterly Pub Date : 2002-01-01
Jean Calhoun, Paula Casey
{"title":"Case management redesign in a managed care system: one company's experience.","authors":"Jean Calhoun,&nbsp;Paula Casey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Strategies for redesign are necessary in successful managed care organizations as the member population grows and changes. This article presents a redesign project initiated by a managed care plan located in the Southwest region of the United States, where the rural frontier blends with metropolitan cities in a culturally diverse population. The focus of this project is the redesign of the Health Services department in which case management resides.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 4","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22224096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Specialty pharmaceuticals: developing a management plan. 特种药品:制定管理计划。
Managed care quarterly Pub Date : 2002-01-01
Dave Willcutts
{"title":"Specialty pharmaceuticals: developing a management plan.","authors":"Dave Willcutts","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This is the first in a series of articles that address the complex issues associated with specialty pharmaceuticals in the development of a successful specialty pharmaceutical program, a critical component of managing this high-cost and highly fragmented sector. This article focuses on how to define specialty pharmaceuticals. Other articles in this series will explore such topics as the mechanics of developing and managing a specialty pharmaceutical program, how and when to establish clinical protocols and authorizations, the importance of data management, and the benefits from automated processes.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 4","pages":"26-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22224099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Take the high road: build trust on the health Internet. 走正道:在健康互联网上建立信任。
Managed care quarterly Pub Date : 2002-01-01
Donald W Kemper, Molly Mettler
{"title":"Take the high road: build trust on the health Internet.","authors":"Donald W Kemper,&nbsp;Molly Mettler","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 1","pages":"47-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25164998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmaceutical company-sponsored disease management programs. 制药公司赞助的疾病管理项目。
Managed care quarterly Pub Date : 2002-01-01
Christopher M Jedrey, Katherine A Chaurette, Lara Beth Winn
{"title":"Pharmaceutical company-sponsored disease management programs.","authors":"Christopher M Jedrey,&nbsp;Katherine A Chaurette,&nbsp;Lara Beth Winn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 1","pages":"56-60"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25165002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmaceutical company sponsored disease management programs: an alternative for tax-exempt MCOs and hospitals. 制药公司赞助的疾病管理项目:免税mco和医院的替代方案。
Managed care quarterly Pub Date : 2002-01-01
Christopher M Jedrey, Katherine A Chaurette, Lara Beth Winn
{"title":"Pharmaceutical company sponsored disease management programs: an alternative for tax-exempt MCOs and hospitals.","authors":"Christopher M Jedrey,&nbsp;Katherine A Chaurette,&nbsp;Lara Beth Winn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On April 25, 2002, the Internal Revenue Service finalized the proposed Corporate Sponsorship regulations. The changes made in the final regulations pertain to the proposed $79 ceiling on disregarded benefits, the 2 percent threshold for disregarded benefits, the scope of disregarded benefits, Web site hyperlinks, the inclusion of certain electronic publications in the definition of periodicals, the valuation date for substantial return benefits, and the scope of use or acknowledgement. The proposed regulations were discussed in the Winter 2002 issue of Managed Care Quarterly in an article titled the same as this one. This article is based on the final IRS regulations and therefore supersedes the original article published in the Winter 2002 issue.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"10 3","pages":"11-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22150899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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