This book links quality and reimbursement issues, using a systems approach that clinicians may incorporate into their practice. 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.Includes a free CD-ROM with customizable forms and checklists.

This book has been updated to provide practical advice for primary care providers (PCPs) about major trends that have emerged over the past several 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 readers with an invaluable set of tools to convert the endless challenges for quality and myriad opportunities for improvement into meaningful and useful change. It considers how to manage primary care organisations in order to improve quality of care; how general practices are regulated and held accountable; various techniques used for assessing and measuring; and commonly used quality improvement frameworks.

"Every NP should own a copy of this book!" - The Nurse Practitioner Journal Written by a nurse practitioner who is also a practicing attorney, Nurse Practitioner's Business Practice and Legal Guide, Second Edition provides the unique point of view of an author who knows what legal and business problems arise on a daily basis. The second edition to this best seller will teach you: --How to write an effective business plan using the most up-to-date information and planning strategies-How to avoid malpractice and other lawsuits-What rights an employed NP has-What to do if rejected for payment-How to effectively negotiate managed care contracts-How to get the highest marks on performance report cards-What must take place for NPs to become primary care providers-What decisions need to be made before starting a practice-How to handle patient flow-And more!Nurse practitioners and NP students who read this book will have a solid foundation of knowledge with which they may continue their practice confidently and effectively, whether it be in developing an employment relationship, undertaking a business venture, giving testimony before the state legislature, composing a letter to an insurance company about an unpaid bill, teaching at a school of nursing, or serving as president of a state or national organization.

This new guide challenges and deconstructs the industry's current standard for the fair market value (FMV) of physician clinical compensation based on the exclusive use of survey data and certain percentile-based valuation methods. Itdebunks the current "survey says" paradigm and provides the foundation for a completely new standard for the FMV of physician clinical compensation.