Knowing what managed care wants helps you succeed

Article Abstract:

Physicians must understand the needs and expectations of managed care gatekeepers if they are to attract and retain new patients, according to Dr Charles Browning, a practice marketing consultant. Knowing what the gatekeepers need and expect from providers will help keep a physician as a preferred provider. Browning advises that physicians accept gatekeepers as here to stay and suggests that they work hard to become part of the managed care team environment by incorporating cost-control measures and healthcare quality-improvement measures into their practices.

HEALTH SERVICES, Direct Health and Medical Insurance Carriers, Health Plan Administration, Management, Medicine, Managed care plans (Medical care), Health insurance industry, Medical practice, Group medical practice

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If Big Brother puts your practice under a microscope

Article Abstract:

Health care firms should prepare themselves for the eventual scrutiny of government agencies that must investigate firms to determine if they have complied to regulations, avoided abuse or fraud. If a practice is run in an ethical manner and maintains careful documentations, problems can be avoided. Physicians do not have to give any information over the telephone to government officials, and confidential patient information should be divulged only with signed and witnessed permission releases from the patient.

Health care industry, Investigations, Administrative agencies, Government agencies

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Knowing how to code can build revenues, relationships

Article Abstract:

Proper coding can bring more money to a physician's practice, allow patients to receive their full insurance benefits and assist insurance companies in processing claims. Physicians should be aware of correct coding procedure; a list of important coding techniques is provided. In addition, a carefully chosen coding expert can review a physician's records to determine whether or not they are coding tests and procedures correctly. Criteria for choosing such an expert are presented.

Health insurance, Records and correspondence, Insurance claims adjustment

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