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[DOCX File]Home Page | LeadingAge
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Under a bundled payment model, providers and/or healthcare facilities are paid a single payment for all the services performed to treat a patient undergoing a specific episode of care. An “episode of care” is the care delivery process for a certain condition or care delivered within a defined period of time.
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[DOC File]What is the Difference Between Health Maintenance ...
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A good example of the Staff Model HMO is Kaiser Permanente. Other physicians are paid a capitated fee by the HMO based on how many services each member (i.e., patient) is likely to use each month. Sometimes doctors are paid more money if they help save the plan money by ordering fewer tests or not referring patients to specialists.
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ANTHEM MIDWEST PROVIDER …
In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide ...
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[DOC File]NCDOI - Home Page
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The minimum financial requirements for an HMO are outlined below. Full Service HMO Single Service HMO Statutory Reference Working Capital $1,500,000 $100,000 NCGS § 58-67-20 Deposits $500,000 $25,000 NCGS § 58-67-25 Net Worth $1,000,000 $50,000 NCGS § 58-67-110
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[DOC File]Are HMOs Really a Dying Breed
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Are HMOs Really a Dying Breed? Jeff Goldsmith and Dan Beckham Debate the Issue. Healthcare Forum Journal (November/December 1998): 52-54. Dan Beckham's "The Beginning of the End for HMOs," a two part article in the Nov./Dec. 1997 and Jan./Feb. 1998 issues of this journal, contends that the capitation/channeling model of healthcare and the entire HMO industry that has been built on it is dying.
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[DOC File]Managed Health Care
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A Health Maintenance Organization (HMO) is an organized system of health care that provides comprehensive services to its members for a fixed, pre paid fee. HMOs are the least expensive form of managed medical care.
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[DOCX File]Managed Care Terminology - NAMSS Home
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Likewise, an HMO must be federally qualified or State plan defined to participate in the Medicaid managed care program. Fee-For-Service (FFS)--A payment system by which doctors, hospitals and other providers are paid a specific amount for each service performed as identified by a claim for payment. Fiscal Soundness
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ANTHEM MIDWEST PROVIDER …
RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company.
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1999 HMO Annual and Quarterly Supplement Report …
Also, please note that the Health Maintenance Organization is subject to penalties pursuant to section §354.444 RSMo if these deadlines are not met. *NOTE: Supplements 2 and 3 are required . annually only. Do not send these supplements with the quarterly filings. Send both supplements with the Annual Filing only. Filing fee: $20.00 (§354.495 ...
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[DOC File]The defining characteristic of a Health Maintenance ...
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Providers in a staff model HMO traditionally are paid a base salary for providing services to the HMO members. This method of compensation is very different from physicians that provide services in a fee-for-service system, where compensation is based on the frequency and complexity of procedures.
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How are hmo providers paid