Healthcare Management: An Introduction

Two MCOs in a single service area divided purchasers into two groups and agreed to each market their products to only one purchaser group. This information indi...

Types of alternative care centers include urgent care centers, observation care units, and stepdown units. One difference between the costs associated with alte...

Using a code for a procedure or diagnosis that is more complex than the actual procedure or diagnosis and that results in higher reimbursement to the provider i...

Utilization data can be transmitted to the health plan manually, by telephone, or electronically. Compared to other methods of data transmittal, manual transmit...

Wellborne HMO provides health-related information to its plan members through an Internet Web site. Laura Knight, a Wellborne plan member, visited Wellborne's W...