Audio and Video | On-Demand CLE
Reflections on the 2024 Final Mental Health Parity and Addiction Equity Act Final Regulations [CC]
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. It then concludes with a deep dive into the legal issues that arise in payer-provider disputes, including the most common issues and case examples.
Log In to view your rate
Unlock the discounted member rate
Join first as a member, and then purchase this product at special member pricing
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.
ABA Book Publishing
9781639053810
202
5630166
6x9
11/16/2023 12:00:00 AM
Audio and Video | On-Demand CLE
Reflections on the 2024 Final Mental Health Parity and Addiction Equity Act Final Regulations [CC]
Audio and Video | On-Demand CLE
Alternative Dispute Resolution Best Practices for Business Attorneys [CC]
Audio and Video | On-Demand CLE
The Nuts and Bolts: An Introduction to ERISA Welfare Plans [CC]
Nov
13
Events | In-Person
National Managed Care Institute 2025
ETHICS 60 min
The National Managed Care Institute is an annual educational symposium hosted by the American Bar Association's Health Law Section for attorneys in private practice, in government service and in-hous…
Sep
29
Events | In-Person
Healthcare Delivery & Innovation Conference
CLE 60 min
The Healthcare Delivery & Innovation Conference is a joint continuing legal education (CLE) event designed for healthcare attorneys, physicians, and related industry professionals.
Jun
04
Events | Webinar
Health Law and Life Sciences Committee Membership Meeting
Join the Health Law and Life Sciences Committee for their quarterly committee membership meeting.