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22 Aug 2023, 7:37 am
On July 20, the Department of Justice announced that physicians and their practices in Missouri and Texas had agreed to pay a total of approximately $525,000 to resolve allegations that they had received kickbacks from purported “managed service organizations” for referring testing services. [read post]
25 May 2016, 7:56 am
Maryland Care, Inc., a managed care organization that administers health care services to more than 190,000 Marylander’s enrolled in the Maryland HealthChoice program, has selected Envolve Inc. to provide health plan management services for its managed Medicaid operations in Maryland effective July 1, 2017. [read post]
9 Sep 2014, 6:30 am
Managed Care through a Preferred Provider Organization A Preferred Provider Organization or PPO is a type of managed care program that is similar to other network-based managed care program such as a Health Maintenance Organization (HMO), Private Fee-For-Service (PFFS) or Point Of Service (POS) program. [read post]
6 Nov 2013, 6:46 am
Physician Review Services Determine Most Appropriate Medical Care Fortunately, the better medical management organizations offer physician review services (PRS) to address whether or not the injured employee is receiving the most appropriate medical care for the injury incurred. [read post]
8 Jul 2013, 6:30 am
Introduce the Preferred Provider Organization to Your Company A preferred (sometimes “participating”) provider organization or PPO is a managed care organization that agrees with a third-party administrator or insurance company to provide their clients with reduced rates. [read post]
4 Apr 2018, 10:48 am
When people in California have health insurance through health management organizations, they normally will go to their in-network providers for care. [read post]
11 Apr 2013, 6:00 am
©2013 Amaxx Risk Solutions, Inc. [read post]
4 Apr 2018, 10:48 am
When people in California have health insurance through health management organizations, they normally will go to their in-network providers for care. [read post]
24 Sep 2013, 6:30 am
©2013 Amaxx Risk Solutions, Inc. [read post]
20 Feb 2012, 5:40 pm
©2012 Amaxx Risk Solutions, Inc. [read post]
3 Nov 2010, 9:14 am
Sarah Hulsey, PHR is the Talent Manager for Rising Medical Solutions, Inc., a national medical cost-containment and care management organization that services the auto, workers’ compensation, and liability insurance markets. [read post]
12 Feb 2011, 5:20 pm
Does the managed care vendor have enough providers in its network to deliver prompt service and provide adequate geographic coverage? [read post]
15 Mar 2019, 8:19 am
The Internal Revenue Service (IRS) exempt organization determination procedures are changing. [read post]
3 Aug 2010, 9:31 pm
©2010 Amaxx Risk Solutions, Inc. [read post]
1 Jul 2018, 9:00 am
These include: Management service organizations arranging for, advertising, or providing medical services rather than only providing administrative staff and services for a physician’s medical practice (non-physician exercising controls over a physician’s medical practice, even where physicians own and operate the business). [read post]
23 Aug 2019, 4:05 am
A pregnant patient may elect medical services necessary to deliver a baby, or to terminate the pregnancy. [read post]
23 Jun 2011, 3:06 pm
NOTE: The Utilization Review Accreditation Commission (URAC) is an umbrella organization responsible for certifying Nurse Case Managers (NCM); Triage Nurses (TN); Telephonic Case Management (TCM); Field Case Management (FCM); Utilization Management/Utilization Review (UM/UR); and Peer-to-Peer Review. [read post]
17 Jun 2010, 10:39 am
Broadspire, a Crawford Company and leading third party administrator of workers’ compensation claims, liability claims and medical management services, has introduced the BOLD network, a custom preferred provider organization (PPO) strategy that includes targeted selection of medical networks on a state-by-state basis to produce superior outcomes for clients. [read post]
22 Sep 2011, 8:56 am
About Progressive Medical Progressive Medical offers cost management services and programs to the workers compensation industry. [read post]
12 Jul 2020, 6:40 pm
According to DOJ’s press release: Universal Health Services, Inc., UHS of Delaware, Inc. [read post]
