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如何与保险公司合作。

How to work with insurance companies.

作者信息

Kaufman Joel M

机构信息

Department of Neurology, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI.

出版信息

Neurol Clin Pract. 2015 Oct;5(5):448-453. doi: 10.1212/CPJ.0000000000000179.

DOI:10.1212/CPJ.0000000000000179
PMID:29443170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5762025/
Abstract

Neurologists in all practice settings will benefit from working better with insurance companies and other payers. This article discusses who the insurance companies and others are that practices should work with, why it is important to maintain and develop ongoing relationships, and several strategies that successful practices of all types employ to achieve success.

摘要

各类医疗机构的神经科医生都将从与保险公司及其他付款方更好地合作中受益。本文讨论了医疗机构应该与之合作的保险公司及其他机构是哪些,维持和发展持续关系为何重要,以及各类成功的医疗机构用以取得成功的若干策略。

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本文引用的文献

1
National health spending in 2013: growth slows, remains in step with the overall economy.2013年国家卫生支出:增长放缓,仍与整体经济同步。
Health Aff (Millwood). 2015 Jan;34(1):150-60. doi: 10.1377/hlthaff.2014.1107. Epub 2014 Dec 3.
2
Analysis Of Medicare Advantage HMOs compared with traditional Medicare shows lower use of many services during 2003-09.分析 2003-09 年期间医疗保险优势 HMO 与传统医疗保险相比的数据显示,前者在许多服务的使用上较低。
Health Aff (Millwood). 2012 Dec;31(12):2609-17. doi: 10.1377/hlthaff.2012.0179.
3
Fee-for-service will remain a feature of major payment reforms, requiring more changes in Medicare physician payment.按服务项目付费仍将是主要支付改革的一个特点,这需要对医疗保险医生支付进行更多的改革。
Health Aff (Millwood). 2012 Sep;31(9):1977-83. doi: 10.1377/hlthaff.2012.0350.
4
The growing power of some providers to win steep payment increases from insurers suggests policy remedies may be needed.一些供应商获得保险公司大幅提价的能力不断增强,这表明可能需要政策补救措施。
Health Aff (Millwood). 2012 May;31(5):973-81. doi: 10.1377/hlthaff.2011.0920.
5
Negotiating with payers.与支付方谈判。
Neurol Clin. 2010 May;28(2):349-64. doi: 10.1016/j.ncl.2009.11.009.