Chapter 11 power point HIT 212

8
The Blue Plans, Private Insurance and Managed Care Plans CHAPTER 11

description

 

Transcript of Chapter 11 power point HIT 212

Page 1: Chapter 11 power point HIT 212

The Blue Plans, Private Insurance and Managed Care Plans

CHAPTER 11

Page 2: Chapter 11 power point HIT 212

HEALTHCARE REFORM

Cost of healthcare

High tech equipment

Expensive medications

Uninsured Americans

Fraud

Inefficency

Page 3: Chapter 11 power point HIT 212

MANAGED CARE SYSTEMS

EPO

“Exclusive”

Regulated by insurance statutes

FMC

Member physicians bill foundation directly

Reimbursement is proportional to number of medical services delivered

Page 4: Chapter 11 power point HIT 212

MANAGED CARE SYSTEMS

IPA

Contractual arrangement to treat HMO patients

Discount of up to 30%

PPO

Coinsurance requires patient to pay 20-25% of allowed amount

“network discount applied”

Pre-certify

Page 5: Chapter 11 power point HIT 212

MANAGED CARE SYSTEMS

PPG

Flexible

Portion of physician income covers joint expenses

Physician owned

POS

Primary care Physician

Use network Providers

Page 6: Chapter 11 power point HIT 212

QUALITY IMPROVEMENT ORGANIZATION

Medically necessary, appropriate and meet standards of care

AKA Professional or Peer Review Organizations

Review and recommend action

Page 7: Chapter 11 power point HIT 212

UTILIZATION REVIEW/MANAGEMENT

Appropriate and efficient use of resources

Cost effective manner

Page 8: Chapter 11 power point HIT 212

PREAUTHORIZATION/PRIOR APPROVAL

VERY IMPORTANT!

Unknown to patients

Must be medically necessary service

ALWAYS CALL!


Hilti HIT-RE 500 con HIT-V / HAS t...Hilti HIT-RE 500 con HIT-V / HAS 2 / 2010 pe 1 Hilti HIT-RE 500 con HIT-V / HAS Sistema di ancoraggio chimico Vantaggi Hilti HIT-RE 500 cartuccia

Hilti HIT-RE 500 con HIT-V / HAS t...Hilti HIT-RE 500 con HIT-V / HAS 2 / 2010 pe 1 Hilti HIT-RE 500 con HIT-V / HAS Sistema di ancoraggio chimico Vantaggi Hilti HIT-RE 500 cartuccia

Hilti HIT-HY 150 MAX with HIT-TZ€¦ · Hilti HIT-HY 150 MAX with HIT-TZ 10 / 2012 560 Hilti HIT-HY 150 MAX with HIT-TZ . Injection mortar system Benefits . Hilti HIT- HY 150 MAX

Hilti HIT-HY 150 MAX with HIT-TZ€¦ · Hilti HIT-HY 150 MAX with HIT-TZ 10 / 2012 560 Hilti HIT-HY 150 MAX with HIT-TZ . Injection mortar system Benefits . Hilti HIT- HY 150 MAX

The plan HIT YOUR S ECOND PEAK - Amazon S3 · HIT YOUR S ECOND PEAK HIT PHASE TWO WITH A POWERFul PuNCH THROuGH THESE SECOND PEAK PlANS The plan IT’S THE midway point of the race

The plan HIT YOUR S ECOND PEAK - Amazon S3 · HIT YOUR S ECOND PEAK HIT PHASE TWO WITH A POWERFul PuNCH THROuGH THESE SECOND PEAK PlANS The plan IT’S THE midway point of the race

START YOUR ENGINES! · Club Med Americas where he oversaw all development, ... when he hit the wall at Michigan International Speedway at 212 MPH. After fourteen surgeries and three

START YOUR ENGINES! · Club Med Americas where he oversaw all development, ... when he hit the wall at Michigan International Speedway at 212 MPH. After fourteen surgeries and three

Chapter 12 HIT 212

Chapter 12 HIT 212

HIT / HIT T

HIT / HIT T

1/ HIT CE Adhesive Anchor System - hilti.fr · PDF fileHilti HIT-1 / HIT-1 CE Concrete Hilti HIT-1/ HIT CE Adhesive Anchor System Injection mortar system Benefits Hilti HIT ... Threaded

1/ HIT CE Adhesive Anchor System - hilti.fr · PDF fileHilti HIT-1 / HIT-1 CE Concrete Hilti HIT-1/ HIT CE Adhesive Anchor System Injection mortar system Benefits Hilti HIT ... Threaded

The Bubble Bursts Consumers – Overused installment plans, then hit saturation point Producers – Mechanization, overproduction caused surplus and deflation.

The Bubble Bursts Consumers – Overused installment plans, then hit saturation point Producers – Mechanization, overproduction caused surplus and deflation.

L2 bench joinery unit 212 power point presentation 1

L2 bench joinery unit 212 power point presentation 1

Photovoltaic modules HIT KURO (N335K) / HIT KURO …

Photovoltaic modules HIT KURO (N335K) / HIT KURO …

Sopranos 110 a Hit is a Hit

Sopranos 110 a Hit is a Hit

Hilti HIT-HY 200 with HIT-Z › medias › sys_master › h65 › h30...Hilti HIT-HY 200 with HIT-Z 10 / 2012 490 Hilti HIT-HY 200 with HIT-Z . Injection mortar system Benefits . cracked

Hilti HIT-HY 200 with HIT-Z › medias › sys_master › h65 › h30...Hilti HIT-HY 200 with HIT-Z 10 / 2012 490 Hilti HIT-HY 200 with HIT-Z . Injection mortar system Benefits . cracked

Hilti HIT-CT 1 with HIT-V€¦ · Hilti HIT-CT 1 with HIT-V 10 / 2012 616 Hilti HIT-CT 1 with HIT-V . Injection mortar system Benefits . Hilti HIT-CT 1 330 ml foil pack (also available

Hilti HIT-CT 1 with HIT-V€¦ · Hilti HIT-CT 1 with HIT-V 10 / 2012 616 Hilti HIT-CT 1 with HIT-V . Injection mortar system Benefits . Hilti HIT-CT 1 330 ml foil pack (also available

The Tipping Point - RNIB Tipping Point Campaign report.pdf · The Tipping Point The human and economic costs of cutting disabled people's support A report from the Hardest Hit coalition

The Tipping Point - RNIB Tipping Point Campaign report.pdf · The Tipping Point The human and economic costs of cutting disabled people's support A report from the Hardest Hit coalition

L2 bench joinery unit 212 power point presentation 4

L2 bench joinery unit 212 power point presentation 4

Allegati - 212 308 - AGRITOMagritom.com.br/site/manuais/LISTA_PECAS_MTS_SANDEI_COMPL_2.pdf · 212/308 s 212/308 pieces de rechange 212/308 tzteil 212/308 piezas de cambio 212/308.

Allegati - 212 308 - AGRITOMagritom.com.br/site/manuais/LISTA_PECAS_MTS_SANDEI_COMPL_2.pdf · 212/308 s 212/308 pieces de rechange 212/308 tzteil 212/308 piezas de cambio 212/308.

Hilti Hit-hy 200 With Hit-V

Hilti Hit-hy 200 With Hit-V

tri hit hit. NitkO bunio

tri hit hit. NitkO bunio

Pop Quiz Time Hit 1, hit 2, hit 3 your in!

Pop Quiz Time Hit 1, hit 2, hit 3 your in!

SURPASS hiT 7070 - centr-postavka.ru Simens Network/Surpass hiT 7070.pdf · Generation Metro, SURPASS hiT 70xx hiT 7020 hiT 7030 hiT 7035 hiT 7025 hiT 7060/HC Емкость hiT 7070

SURPASS hiT 7070 - centr-postavka.ru Simens Network/Surpass hiT 7070.pdf · Generation Metro, SURPASS hiT 70xx hiT 7020 hiT 7030 hiT 7035 hiT 7025 hiT 7060/HC Емкость hiT 7070