Physician credentialing in managed care.

Ratings of physician communication by real and standardized patients.

PURPOSE Patient ratings of physician's patient-centered communication are used by various specialty credentialing organizations and managed care organizations as a measure of physician communication skills. We wanted to compare ratings by real patients with ratings by standardized patients of physician communication. METHODS We assessed physician communication using a modified version of the ...

Managing care in an integrated delivery system via an Intranet

The CareGroup Provider Service Network is a managed care contracting organization which provides central administrative services for over 1800 physicians and 200,000 managed care lives. Services include utilization management, disease management and credentialing for the entire network. The management model of the Provider Service Network empowers local physician groups with information and edu...

Licensing and credentialing of health care providers.

State regulation of managed care: the impact on children.

As more and more children enroll in managed care, states have responded to concerns expressed by their constituents by passing legislation and developing credentialing requirements to assist families with children in receiving appropriate care from managed care plans. Although most of the legislation and credentialing requirements apply to the population generally, a few provisions apply specif...

Are managed care organizations in the United States impeding the delivery of primary care by nurse practitioners? A 2012 update on managed care organization credentialing and reimbursement practices.

In 2014, the Affordable Care Act will create an estimated 16 million newly insured people. Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis. NPs are health care professionals wit...