Field Guide to the Business of Medicine: Resource for Health Care Professionals

by Christopher Clyne, Britton Jewell

Overview

Today’s health care is much more than Medicine. Health care professionals and administrators must be familiar with the non-medical aspects of health care if they are to be successful. From the basics of government and private insurance, to reimbursement methods, payment models, practice paradigms and new industry trends this indispensable guide provides much-needed information for medical students and residents, emerging health care professionals, and anyone who wants a clear perspective on the requisites, protocols, and regulations of today’s health care system.

• Delivers up-to-date, must-know information on today’s changing health care system, recent reforms, and the economics of practicing medicine – areas that are critical to career decision making and professional success.
• Uses an easy-to-read, quick-reference format that features numerous tables, diagrams, and links for efficient learning.
• Covers practical business and administrative challenges not often addressed in medical school and other formal health care training: credentialing, schedule planning, budgeting, benefits coverage, and much more.
• Includes practical coverage of insurance plans, physician reimbursement, documentation, billing and coding, medical malpractice and health law, social media, and more.
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Product Details

ISBN-13:	9781496396235
Publisher:	LWW
Publication date:	01/08/2019
Pages:	192
Product dimensions:	5.90(w) x 8.90(h) x 0.40(d)

Table of Contents

Contributors vii

Foreword viii

Preface ix

Acknowledgments x

Introduction: Business of Health Care 101 1

1 Fundamentals of Health Insurance: Medicare and Medicaid 3

2 Primer on Health Plans: Private Insurance 15

3 Physician Reimbursement: How Doctors Are Paid 23

4 Nonprofit or Not: How Hospitals Are Paid 33

5 Advanced Practitioners to the Rescue: How Other Providers Are Paid 43

6 If It Ain't Written It Ain't Done: Basics of Documentation and Electronic Health Records 51

7 Charging Responsibly: Clinical Documentation Integrity and Risk Adjustment 61

8 Big Brother is Watching: Quality and Compliance 69

9 Your Virtual Presence: Navigating Social Media 79

10 Protect Yourself: Medical Malpractice and Health Law 83

11 Piles of Paperwork: Licensing, Certification, and Credentialing 95

12 It Takes a Village: Social Work and the Community 101

13 Carving Your Niche: Practice Paradigms 113

14 From Bedside to Boardroom: The C-Suite 123

15 The Health Care Executive: Industry as a Career 133

16 The Game Changer: The Affordable Care Act and Its Future 139

17 Spotting the Horizon: Future Directions in Health Care 153

Appendix 1 Directory of State Board Websites 155

Appendix 2 Directory of States Requiring Controlled Substance License 161

Index 163