Healthcare Practice Management Consultants Key Terms

Terms you will run across as you investigate health care practice management consultants

Healthcare practice management consultants help medical practices and professionals manage the day-to-day operations of a medical practice so the staff can focus on providing care to patients. Because almost every doctor’s visit requires insurance coordination, a major part of the resources in a doctor’s office can be improved and streamlined with the assistance of a knowledgeable consultant. As you explore the type of consultant that would best fit your needs it would behoove you to understand some basic terms.

 

Managed care

Managed care is comprised of a number of techniques that are employed to reduce the cost of providing health benefits and improving the quality of care provided by health care practitioners. Healthcare practice management consultants offer managed care services to health care institutions and professionals.
Try: MedicineNet discusses this topic in more detail.

HIPAA

HIPAA or Health Insurance Portability and Accountability Act, was enacted in 1996 and provides for the protection of health insurance coverage for workers and their families when they change or lose their jobs. As part of this act there were standards established for electronic health care transactions that help keep information private. Healthcare practice management consultants provide services on managing this law in a medical practice.
Try: Go to TechTarget for more information.

CLIA

CLIA or clinical laboratory improvement amendments were passed in 1988 and are federal standards that apply to all clinical laboratory testing that is performed on humans in the U.S. Some healthcare practice management consultants provide information and services related to these amendments.
Try: Farlex defines this term for you.

Credentialing

Credentialing is the process of evaluating the background and legitimacy of licensed professionals. Healthcare practice management consultants provide credentialing verification as part of their services.
Try: See BusinessDictionary.com for another definition.

Receivables management

Receivables management refers to the processes associated with the management of customers who owe money to a healthcare institution or medical practice. Some healthcare practice management consultants can provide receivables management.
Try: Magnolia Financial provides a good overview of how receivables management is done. Dekaye Consulting describes their five point plan for AR management in a medical practice.

NCQA

NCQA or the National Committee for Quality Assurance is a non-profit organization that was set up to improve the quality of health care. NCQA manages voluntary accreditation programs for physicians and medical groups. Healthcare practice management consultants can provide assistance with the accreditation processes that are managed by NCQA.
Try: NCQA is the official website for this organization.

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