decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Health Maintenance Organizations / Overview
Subscribe or sign in to view the full article.
Article Overview
This article explains the basic structure and purpose of health maintenance organizations (HMOs), including how they are organized, regulated, and used within managed care. It also touches on broad contracting and enrollment considerations that may be relevant to practices working with HMO arrangements. The content is useful for administrators, practice managers, and coding or billing staff who need a general understanding of HMO-related payer relationships.
Why This Topic Matters
Understanding HMO organization and contracting helps practices recognize managed care arrangements that can affect patient flow, provider participation, and administrative workflow. This background is relevant when evaluating payer relationships and planning how services are delivered within HMO-based care models.
What You Will Learn
- What an HMO is in general terms
- How HMOs fit into managed care
- The role of regulation in HMO health plans
- Broad considerations for provider contracting and enrollment
- General implications of HMO arrangements for medical practices
Who Should Read This
- Practice managers
- Medical office staff
- Billing and coding professionals
- Healthcare administrators
- Physician group leaders
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com