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An Introduction to Managed Care
Challenges and Opportunities for Nurses
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accreditation addition agement appropriate assessment benefits Challenges and Opportunities cian clinical pathways concurrent review contract coordinators cost create credentialing decisions demand management determine developed diabetes diagnosis discharge disease management programs documentation employers ethics evaluation EXAM QUESTIONS CHAPTER facilities focus focused goals health plan health risk healthcare delivery system healthcare organizations healthcare providers healthcare services high risk hospital identify improve independent practice association inpatient interventions JCAHO length of stay liability malpractice managed care organization managing patients measures medical necessity Medicare ment monitoring NCQA nurse model Opportunities for Nurses organiza outcomes management patient satisfaction payers payment physi physician potential practice guidelines practitioners Preventive Health procedures professional prospective review protocols RBRVS referral reimbursement result role Sample screening specialty specific standards strategies tele-medicine tion Total Quality Management treatment Understanding Managed utilization management utilization review variance vicarious liability