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The Primary Care Provider's Guide to Compensation and Quality: How to Get Paid and Not Get Sued, Second Edition

Author(s): Carolyn Buppert, CRNP, JD, Attorney, Bethesda, Maryland
Details:
  • ISBN-13: 9780763729585
  • ISBN-10:0763729582
  • Spiral/paperback    458 pages      © 2005
Price: International Sales $170.95 US List
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Overview

This book has been 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. 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.

 

 

ShowTable of Contents

Chapter One: 
Measuring Performance in Primary Care

Chapter Two: 
Systems for Meeting Benchmarks for Screening and Health Maintenance

Chapter Three: 
Measuring Outcomes in Primary Care

Chapter Four: 
Systems for Measuring Outcomes at the Practice Level

Chapter Five: 
Systems for Tracking Functional Status

Chapter Six: 
Systems for Measuring and Tracking Patient Satisfaction

Chapter Seven: 
Malpractice: The Ultimate Failure in Quality

Chapter Eight: 
Systems for Avoiding Malpractice

Chapter Nine: 
Reimbursement for Primary Care

Chapter Ten: 
What is Fraud and Abuse in Billing?

Chapter Eleven: 
Systems for Complying with Requirements of Medicare and Other Payers

Chapter Twelve: 
How to Contract with Managed Care Organizations

Chapter Thirteen: 
How to Maximize Reimbursement

Appendix A: 
Checklist Documentation Forms

Index


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ShowAbout the Author(s)

Carolyn Buppert, CRNP, JD-Attorney, Bethesda, Maryland

Expert advice from a highly qualified author…

Carolyn Buppert, MSN, JD, ANP, is uniquely qualified to provide expert, practical business and legal guidance to NP, prospective NPs, and those who employ them.  She currently maintains a legal practice specializing in legal and business issues in primary care.  She is president of Better Life in Health Care Systems, which contracts with businesses for NP services.  She also practices as an NP as Director of Student Health at St. John’s College in Bethesda, MD.

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ShowReviews

  • "Overall, this book offers useful and informative guidelines for primary care providers. It is truly an exceptional book for healthcare providers, and one of a kind written by a nurse practitioner attorney whose judgment is trustworthy. Because of frequent legislative changes that result in legal pitfalls and inadequate reimbursement, this second edition is justified in replacing the 2000 publication."

    Nancy A. Johnson, RN, MSN, WHNP
    Texas University Health Sciences Center
    Doody Enterprises, Inc.

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