ITEMS IN FPM ON TOPIC:
Health plans, general
This article explains why physicians should appeal some health plan denials with their patients, and it gives suggestions about how to improve their chances when they do appeal.
Open letter to the CEO of United Health Care, the Academy health plan, discussing improvements and user control.
This article provides an overview of what has happened to health care reform since the Clinton administration's failed attempts in the mid-1990s and focuses on the efforts of the Physician Work Group on Universal Coverage to bring health care for the uninsured to the forefront in this election year.
Argues that capitation is still a good idea despite its current bad name, and that advances in technology and the organization of the health care system may still make it a desirable and achievable payment mode.
How to get paid for noncredentialed physicians. Why it takes so long to get credentialed. What physicians can do in the meantime? What they can do to make it happen more quickly.
Argues for large physician organizations as a way of keeping the proper balance between the clinical and the financial rather than letting nonphysician managed care organizations emphasize the financial at the expense of the clinical.
A letter of protest to a managed care company that protested his patient's use of 8 Viagra tablets in a single month when the average is 5.9
This article describes how one practice developed its own drug formulary to help overcome the hassles of trying to prescribe according to the formularies of several managed care plans.
Using analogies to baseball, the author describes a method for coping with and managing changes in the health care system.
This article discusses the most significant hassle factors related to the business side of practice that FPs face in carrying many different managed care plans, and it will recommend ways that FPs can manage those hassles.