AHLA Health Plans Contracting Handbook: A Guide for Payors and Providers, Sixth Edition with CD-ROM (AHLA Members)

American Health Lawyers Association

Availability: In Stock
Publisher :AHLA

Available Formats:

Available Formats

BOOK

Electronic book:epub ,for e-readers, including Adobe® Digital Editions, Apple® iPad®, SONY® Reader

Electronic book:mobi ,for Mobipocket readers including Amazon® Kindle®

BOOK

Detail

Quantity:

$169.00

ISBN:9781422495674
2011 | See description and further details below

Electronic book:epub

Detail

Quantity:

$169.00

Electronic book:mobi

Detail

Quantity:

$169.00

ISBN:9780327170907
2011 | See description and further details below

If you are not an AHLA member and would like to purchase this book, click here.

The Health Plans Contracting Handbook, Sixth Edition from AHLA traces the managed care contracting process from preparing to negotiate the contract, to formation and implementation, to termination issues. It identifies key questions typically encountered in preparing such agreements with a perspective that incorporates the current environmental challenges confronting managed care organizations, including the impact that healthcare reform issues will have on Provider-Payor relations. The Handbook considers the interests of Payors alongside those of providers and juxtaposes sample Provider-Friendly and Payor-Friendly language in order to help frame the negotiation and documentation of the parties' competing interests. It also offers separate chapters on Medicare and Medicaid managed care contracting in recognition of the growing significance that governmental Payors will have in years to come. Each chapter finishes with a bullet-point checklist of key considerations and a list of other useful resources, including both print and web-based sources. A complete collection of sample clauses is provided on the enclosed CD-ROM, so you can draft and customize your clients' contracts more efficiently.

AUTHORS
Cynthia F. Reaves, Esquire, Editor
Anna W. Hance, Esquire, Co-Editor
Robert M. Keenan III, Esquire, Co-Editor

Matthew P. Amodeo, Esquire
George W. Bodenger, Esquire
Robin J. Fisk, Esquire
Lisa G. Han, Esquire
John M. Kirsner, Esquire
Mark S. Kopson, Esquire
Kathrin E. Kudner, Esquire
Steven J. Lauwers, Esquire
Thomas P. O'Donnell, Esquire
Jacqueline Penrod, Esquire
Richard H. Sanders, Esquire
Michael F. Schaff, Esquire
Adam C. Varley, Esquire

The eBook versions of this title feature links to Lexis Advance for further legal research options.

Preface
About the Editors and Authors
Acknowledgments
Introduction

1. Basics of Negotiating
Richard H. Sanders

2. Antitrust Issues in Managed Care Contracting
John M. Kirsner

3. Key Contract Definitions
Matthew P. Amodeo

4. Payor Programs and Policies: Utilization Management and Quality Assurance
Robin J. Fisk

5. Risk-Based Payment Methods
George W. Bodenger

6. Term and Termination Provisions
Michael F. Schaff

7. Insurance Requirements and Indemnification
Kathrin E. Kudner

8. Other Cotnract Provisions
Mark S. Kopson

9. Dispute Resolution
Thomas P. O'Donnell

10. Protecting Against Insolvency
John A. Meyers

11. Government Payors
Lisa G. Han

Appendix A - Glossary of Health Plan Contracting Terms
Appendix B - Table of Sample Clauses
Appendix C - Physician Group Practice Provider Agreement Template with Commentary

Cynthia F. Reaves, Editor
Anna W. Hance, Co-Editor
Robert M. Keenan III, Co-Editor

Matthew P. Amodeo
George W. Bodenger
Robin J. Fisk
Lisa G. Han
John M. Kirsner
Mark S. Kopson
Kathrin E. Kudner
Steven J. Lauwers
Thomas P. O'Donnell
Jacqueline Penrod
Richard H. Sanders
Michael F. Schaff
Adam C. Varley

American Health Lawyers Association (AHLA)

Leading health law to excellence through education, information, and dialogue, the American Health Lawyers Association (AHLA) is the nation's largest, nonpartisan, 501(c)(3) educational organization devoted to legal issues in the healthcare field. AHLA provides a wide variety of resources to address the issues faced by law firms, government, in-house counsel and academia and those who represent the entire spectrum of the health industry.

Printable Reviews

The item you are trying to order is restricted to a quantity of 1 per order. Please complete the current order and place a new order for additional copy.

We are currently experiencing difficulties in adding this product to the cart. Please contact customer support at 1-800-543-6862 for assistance. You may continue to shop for other products in the store.