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Essentials of Managed Health Care

Peter R. Kongstvedt

©2013  
ISBN: 9781449653316
List of Content Removed Due to Copyright Restrictions  

Description
An authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance.
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661 pages
$125.59  Color
$105.76  B&W
$59.49  eBook
  • 18 pages
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    Chapter 1 A History of Managed Health Insurance and
    Managed Health Care
    Author: Peter D. Fox; Peter R. Kongstvedt

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  • 25 pages
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    Chapter 2 Types of Health Insurers, Managed Health
    Care Organizations, and Integrated Health
    Care Delivery Systems
    Author: Eric R. Wagner; Peter R. Kongstvedt

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  • 9 pages
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    Chapter 3 Elements of the Management and Governance
    Structure
    Author: Peter R. Kongstvedt

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  • 28 pages
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    Chapter 4 The Provider Network
    Author: Peter R. Kongstvedt

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  • 53 pages
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    Chapter 5 Provider Payment
    Author: Peter R. Kongstvedt

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  • 32 pages
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    Chapter 6 Legal Issues in Provider Contracting
    Author: Mark S. Joffe; Kelli D. Back

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  • 46 pages
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    Chapter 7 Basic Utilization and Case Management
    Author: Peter R. Kongstvedt

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  • 10 pages
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    Chapter 8 Fundamentals and Core Competencies of Disease
    Management
    Author: David W. Plocher

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  • 14 pages
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    Chapter 9 Physician Practice Behavior and Managed
    Health Care
    Author: Jay Want; Peter R. Kongstvedt

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  • 14 pages
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    Chapter 10 Data Analysis and Provider Profiling in
    Health Plans
    Author: David W. Plocher; Nancy Garrett

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  • 26 pages
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    Chapter 11 Prescription Drug Benefits in Managed Care
    Author: Robert P. Navarro; Craig S. Stern; Rusty Hailey

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  • 19 pages
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    Chapter 12 Introduction to Managed Behavioral Health
    Care Organization
    Author: Joann Albright; Deborah Heggie; Anthony M. Kotin; Connie Salgy; Wanda Sullivan; Fred Waxenberg

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  • 12 pages
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    Chapter 13 Disease Prevention in Managed Health Care
    Plans
    Author: Marc Manely

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  • 12 pages
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    Chapter 14 Quality Management in Managed Health Care
    Author: Pamela B. Siren

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  • 24 pages
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    Chapter 15 Accreditation and Performance Measurement
    Programs in Managed Health Care
    Author: Margaret E. O’Kane

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  • 12 pages
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    Chapter 16 Marketing and Sales
    Author: Richard Birhanzel

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  • 17 pages
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    Chapter 17 Enrollment and Billing
    Author: Karl V. Kovacs; Scott McDaniel; Peter R. Kongstvedt

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  • 40 pages
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    Chapter 18 Claims and Benefits Administration
    Author: Donald L. Fowler, Jr.; Elizabeth A. Pascuzzi

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  • 13 pages
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    Chapter 19 Health Care Fraud and Abuse
    Author: Christie A. Moon

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  • 22 pages
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    Chapter 20 Member Services
    Author: Kevin Knarr; Peter R. Kongstvedt

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  • 16 pages
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    Chapter 21 Operational Finance and Budgeting
    Author: Dale F. Cook; Christopher R. Campbell

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  • 9 pages
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    Chapter 22 Underwriting and Rating
    Author: Michael G. Strum; Troy M. Filipek

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  • 15 pages
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    Chapter 23 Information Systems and Electronic Data
    interchange in Managed Health Care
    Author: James S. Slubowski

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  • 28 pages
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    Chapter 24 Health Plans and Medicare
    Author: John K. Gorman; Jean D. LeMasurier; William A. MacBain; Stephen J. Balcerzak; Wendy K. Burger; Amy Huang

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  • 31 pages
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    Chapter 25 Medicaid Managed Health Care
    Author: Rodney C. Armstead; Catherine K. Anderson; Elizabeth Cabot Nash

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  • 18 pages
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    Chapter 26 The Military Managed Care Health System
    Author: M. Nicholas Coppola; Ronald P. Hudak; Forest S. Kim; Lawrence Fulton; Jeffrey P. Harrison; Bernie J. Kerr, Jr.

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  • 17 pages
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    Chapter 27 Managed Care in a Global Context
    Author: Jonathan P. Weiner; Emily Adrion; Joanna Case Famadas; Djordje Gikic; Hugh R. Waters

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  • 11 pages
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    Chapter 28 State Regulation of Managed Health Care
    Author: Tom Wilder

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  • 14 pages
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    Chapter 29 Federal Regulation of Health Insurance and
    Managed Health Care
    Author: Tom Wilder

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  • 16 pages
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    Chapter 30 The Patient Protection and Affordable Care
    Act
    Author: Tom Wilder

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  • 40 pages
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    Chapter 31 Glossary
    Author: Peter R. Kongstvedt

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