One of the most important aspects in managed care is the network of providers. Physicians compose...

One of the most important aspects in managed care is the network of providers. Physicians compose a large part of this network. Prior to signing a contract with the managed care organization, a physician must meet the payer's credentialing standards. Discuss some common aspects of the physician credentialing process. Also, address some possible problems that may arise if credentialing was not completed. Be sure to properly cite any sources you may use.

Expert Solution

Rahul Sunny answered 2 years ago

Describe the constraints/challenges that physicians experience as being service providers affiliated with a Managed Care Organization....

Describe the constraints/challenges that physicians experience as being service providers affiliated with a Managed Care Organization. (Minimum 2 paragraphs including in-text citations and references in proper APA format)

11. Under managed health care, participating providers (e.g., physicians) negotiate specific a reimbursement mechanism which determines...

11. Under managed health care, participating providers (e.g., physicians) negotiate specific a reimbursement mechanism which determines how they will be paid for the services they deliver. Select one: a. true b. false

what are the three most important aspects to working in a health care team?

There is a growing shortage of nurses and primary care providers (e.g., primary care physicians, nurse...

There is a growing shortage of nurses and primary care providers (e.g., primary care physicians, nurse practitioners, and physician assistants) in the United States. Explores the reasons behind the shortage of nurses or primary care providers. Discuss some ways that the federal and state governments may help to alleviate the shortages. Consider discussing nursing or primary care provider shortages as they pertain to North Carolina. introduction, body, conclusion, and reference page, per the 7th edition of the APA Publication Manual....

Describe the costs and benefits of systems that use non-physicians as primary-care providers. .

One of the most important aspects to project evaluation is to make a correct estimate of...

One of the most important aspects to project evaluation is to make a correct estimate of the discount rate. Explain how the “discount rate” is derived and assess its significance in relation to other factors that are also important to project evaluation. i want minimum 800 words.

Kongstvedt (2013) notes that the management of utilization is one of the most important aspects of...

Kongstvedt (2013) notes that the management of utilization is one of the most important aspects of controlling overall healthcare costs. Methods used vary from weak and mechanical to tightly managed. Develop a policy and procedure for managing ancillary utilization in a managed care plan. Be specific regarding the type of ancillary service and explain how this policy and procedure will: Maximize resources Contain costs Ensure that appropriate care is provided

Interpret managed care contract agreements and gain familiarity with language and strategies used by providers and...

Interpret managed care contract agreements and gain familiarity with language and strategies used by providers and managed care organizations. Comparative analysis of managed care contracts

How do health care providers (not just physicians) access prescription drugs that are used to feed...

How do health care providers (not just physicians) access prescription drugs that are used to feed their addiction?

Ernest and Young conducts its Decision-making in one of the most important aspects of their services...

Ernest and Young conducts its Decision-making in one of the most important aspects of their services to small businesses, but the process of arriving at a decision is quite precise, it yields the best results for their client executive team as they conduct major decisions. There are a few smaller decisions that managers and staff members will make, sometimes without input. To ensure that decision-making is uniform throughout your organization, the implementation process is carefully followed. 7. Create a decision-making...

Question