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In the Business of Medicine community, each resident, fellow or physician will walk away with an understanding of the key components of running a successful medical practice such as accounts receivable, managed care and legal and regulatory.

 

 

Most Recent Articles

  • How to Increase the Number of Primary Care Physicians

    How to Increase the Number of Primary Care Physicians Demand for Doctors Reaches All-Time High By Art Young Takeaways The recently passed healthcare act will give new insurance coverage to 32 million people Because of a lack of compensation, there are not enough primary care physicians Solutions to this challenge will come from innovative new policies The recently passed healthcare reform legislation in the United States will soon give 32 ...
  • Managed Care - Market Analysis and Strategy Development

    Why is it important? It is Friday night and your high school football team is playing in the state championship playoffs. It is imperative for your team to know: a) the strengths and weakness of the other team b) when to call a certain play to gain optimal yardage c) where the ball must be to score points d) what plays to call to score points e) all of the above The practice you are evaluating is much like your high school football team. The ...
  • Managed Care - Contract Evaluation

    Contract evaluation is a process that every practice should have defined and documented. This can be a simple checklist or as sophisticated as a weighted calculated system. Either way, the process should be documented and utilized by all of the individuals who have contracting authority. Exhibit E is an example if a checklist used to review fee for service contracts. The practice should develop and continue to refine the list as an ongoing ...

Most Recent Terms

  • American Medical Accreditation Program (AMAP)

    A program for individual physician quality accreditation launched by the American Medical Association, in partnership with state and county medical associations and national medical societies. http://www.cmss.org/index.cfm?p=readmore&itemID=1119&detail...
    by admin on 05-07-2009
  • American Board of Medical Specialties (ABMS)

    A twenty-four member board who certify and re-certify physicians in their respective specialties. To provide assurance to the public that those certified by an ABMS Member Board have successfully completed an approved training program and an evaluation...
    by admin on 05-07-2009
  • Point of Service (POS)

    An insurance model which determines coverage by where care is provided at the time of delivery, rather than by enrollment. POS plans allow enrollees to choose between a network and out-of-network providers. Network or contracted providers are paid on...
    by admin on 05-07-2009
  • Economic Credentialing

    The use of economic criteria unrelated to quality of care or professional competence in determining a physician's qualifications for initial or continuing hospital medical staff membership or privileges. (AMA Policy H-230.975) http://www.ama-assn...
    by admin on 05-07-2009
  • Delegated Credentialing

    To delegate all or some aspects of the physician credentialing process to outside organizations. http://www.mcres.com/mcrmm08.htm
    by admin on 05-07-2009
  • Credentialing Verification Organizations (CVOs)

    An organization responsible for checking the credentials of medical professionals and confirms they are qualified to seek and/or maintain privileges or participate with managed care plans. An organization whose primary responsibility is to ensure no impostors...
    by admin on 05-07-2009
  • Managed Care Organization (MCO)

    Entities that serve Medicare or Medicaid beneficiaries on a risk basis through a network of employed or affiliated providers. The term generally includes HMOs, PPOs, and Point of Service plans. In the Medicaid world, other organizations may set up managed...
    by admin on 05-07-2009
  • Credentialing

    The process of giving evidence of your medical capabilities to the organizations that give you authority to and/or pay for you to practice medicine. It ensures that only qualified individuals are allowed to practice, minimizing liability for hospitals...
    by admin on 05-07-2009
  • Credentialing File

    A file or files containing a copy of just about every official document pertinent to the physician, to be used in the process of substantiating a physician's credentials. http://www.ascrs.org/publications/ao/ae10_4_georgian.htm
    by admin on 05-07-2009
  • Primary Source

    The original source of a specific credential that can verify the accuracy of a qualification reported by an applicant. Examples include medical school, graduate medical education program, and state medical board. The credentialing process and primary...
    by admin on 05-07-2009
  • Values

    Intrinsic and extrinsic things that are important to you, like achievement, status and autonomy. Intrinsic values are related to the work itself and what it contributes to society. Extrinsic values include external features, such as physical setting and...
    by admin on 05-07-2009
  • SPs, SJs, NFs, and NTs

    Myers's sixteen types into four groups, personally configured to show temperament, character, personality, and predisposition to develop certain attitudes and not others. http://keirsey.com/pumII/temper.html
    by admin on 05-07-2009
  • Utilization

    Use of services and supplies. Utilization is commonly examined in terms of patterns or rates of use of a single service or type of service such as hospital care, physician visits, prescription drugs. Measurement of utilization of all medical services...
    by admin on 05-07-2009
  • Utilization Review (UR), Utilization Management (UM)

    Evaluation of the necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities. In a hospital, this includes review of the appropriateness of admissions, services ordered and provided, length of a stay, and...
    by admin on 05-07-2009
  • Triple Option Plan

    Also referred to as a "cafeteria plan", TOP's offer subscribing employees a choice between regular indemnity plans, HMO or PPO plans. During "open enrollment periods" they have the option of switching coverage plans. CareerPhysician
    by admin on 05-07-2009

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