The Primary Care Provider's Guide to Compensation and Quality: How to Get Paid and Not Get Sued, 2nd Edition
Carolyn Buppert, CRNP, JD
Spiral-bound: 458 pages + bonus CD-ROM
Jones & Bartlett
(click below for the very best currently available price for this title)
This book has been updated to provide practical advice for primary care providers (PCPs) about major trends that have emerged over the past five years, such as growing patient enrollment in managed care health plans, performance evaluation of PCPs by outside agencies, and the dramatic increase in billing being audited.
This book links quality and reimbursement issues, using a systems approach that clinicians may incorporate into their practice. The included CD-ROM contains customizable forms, with checklist progress note forms for the 20 most common primary care diagnoses and checklists of 20 primary care tasks for HEDIS measurements.
This book provides practical advice for primary care providers (PCPs) about major trends that have emerged over the past five years, such as growing patient enrollment in managed care health plans, performance evaluation of PCPs by outside agencies, and the dramatic increase in billing being audited. This book links quality and reimbursement issues, using a systems approach that clinicians may incorporate into their practice.
Customizable forms on the CD-ROM include checklist progress note forms for the 20 most common primary care diagnoses and checklists of 20 primary care tasks for HEDIS measurements. This spiral-bound guide explains Medicare rules and offers practical advice on issues of reimbursement and risk. The book outlines a systems approach to:
- understanding the measurement of performance
- screening and health maintenance
- outcomes measurement
- tracking functional status
- patient satisfaction
- malpractice avoidance
- billing fraud
- Medicare requirements
- managed care contracts, and
- related topics.
Reproducible checklists are included, both in paper and electronic (CD-ROM) form. Contents of this book include:
- Measuring Performance in Primary Care
- Systems for Meeting Benchmarks for Screening and Health Maintenance
- Measuring Outcomes in Primary Care
- Systems for Measuring Outcomes at the Practice Level
- Systems for Tracking Functional Status
- Systems for Measuring and Tracking Patient Satisfaction
- Malpractice: The Ultimate Failure in Quality
- Systems for Avoiding Malpractice
- Reimbursement for Primary Care
- What is Fraud and Abuse in Billing?
- Systems for Complying with Requirements of Medicare and Other Payers
- How to Contract with Managed Care Organizations
- How to Maximize Reimbursement
Carolyn Buppert, MSN, JD, ANP, is uniquely qualified to provide expert, practical business and legal guidance to NP, prospective NPs, and those who employ them. She currently maintains a legal practice specializing in legal and business issues in primary care. She is president of Better Life in Health Care Systems, which contracts with businesses for NP services. She also practices as an NP as Director of Student Health at St. John’s College in Annapolis, MD.
"This book offers useful and informative guidelines for primary care providers. It is truly an exceptional book for healthcare providers, and one of a kind written by a nurse practitioner attorney whose judgment is trustworthy. Because of frequent legislative changes that result in legal pitfalls and inadequate reimbursement, this second edition is justified in replacing the 2000 publication." - Nancy A. Johnson, RN, MSN, WHNP, Texas University Health Sciences Center
(information provided by the publisher)
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