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The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California. The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting ...
This dual regulation arose due for historical reasons, and when the DMHC was created in 2000, [2] the California legislature requested a report [2] on merging the health insurer responsibilities with the CDI. [3]
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed. [1] This bill is called a claim. [2]
Center for Improvement in Healthcare Quality (CIHQ) [3] Commission on Accreditation of Rehabilitation Facilities (CARF) Community Health Accreditation Program(CHAP) DNV GL Healthcare; Foundation for the Accreditation of Cellular Therapy (FACT) [4] Global Healthcare Accreditation (GHA) [5] Healthcare Facilities Accreditation Program (HFAP)
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
DMHC can refer to: California Department of Managed Health Care State of California government agency, United States. Dickinson Mental Health Center in Pennsylvania , United States
Nurse-managed health centers also focus on preventive health care, especially regarding certain chronic conditions like asthma, hypertension, diabetes, and obesity. This focus on preventative, holistic health care has been shown to reduce emergency room usage and decrease the length of hospital stays among nurse-managed health center patients.