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The procedure of developing, maintaining, and monitoring the chargemaster and its pricing scheme often necessitates multiple hospital employees working under the supervision of a "chargemaster coordinator", [10] [11] a "charge master manager", or others in the health care system's operations or administrative support areas frequently called a ...
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
Project portfolio management (PPM) is the centralized management of the processes, methods, and technologies used by project managers and project management offices (PMOs) to analyze and collectively manage current or proposed projects based on numerous key characteristics.
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 ...
The company's services include providing validated insurance and helping find liable third parties. Their program integrity services identify improper payments and over-payments and attempt recovery, as well as reduce fraud and waste. In addition, the company also supports Medicaid Managed Care Organizations and Medicare Advantage Plans. [3]
In 2013, HMR became a subsidiary of Merck & Co., Inc. and was part of Merck's Healthcare Services & Solutions, a separate entity from the pharmaceutical business, which focuses on improving the healthcare experience for patients, providers, and payers. [2] In January 2020, HMR was acquired by Providence St. Joseph Health. [3] [4]
Morgan Ortagus, a Donald Trump critic turned supporter, will serve as his deputy special envoy for Middle East peace.
The patient health record is the primary legal record documenting the health care services provided to a person in any aspect of the health care system. The term includes routine clinical or office records, records of care in any health related setting, preventive care, lifestyle evaluation, research protocols and various clinical databases.