The Risk Manager's Desk Reference / Edition 2

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Overview

The Risk Manager's Desk Reference, Second Edition is the definitive guide to ensure quality in your organization and save thousands of dollars in costly lawsuits. It puts at your fingertips the information you need on integrating quality assurance and risk management, understanding risk management in a managed care environment, and program development. With this book you learn how to integrate patient support services and facilitate physician participation. This handy reference offers concise information on your most challenging issues and various ethical issues.

"...extensively revised and updated to reflect the changing demands of the managed care environment...describes the risks involved in managed care, how to avoid fraud and abuse charges, setting up corporate compliance programs, etc."

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Product Details

  • ISBN-13: 9780834210165
  • Publisher: Jones & Barlett Learning
  • Publication date: 3/3/1998
  • Edition description: 2E
  • Edition number: 2
  • Pages: 519
  • Product dimensions: 7.00 (w) x 10.10 (h) x 1.30 (d)

Table of Contents

Contributors
Introduction
Ch. 1 Introduction to Risk Management 1
Ch. 2 Risk Management in Managed Care 5
Ch. 3 The Risk Manager's Role in the Integrated Delivery System 19
Ch. 4 Integrating Risk Management, Utilization Management, and Quality Management: Maximizing Benefit through Integration 27
Ch. 5 Incorporating Quality Improvement Strategies and Benchmarking into Risk Management 43
Ch. 6 Benchmarking in Risk Management 56
Ch. 7 Risk Management Strategic Planning for a Changed Health Care Delivery System 61
Ch. 8 Developing Tools To Identify and Manage the Risks of Managed Care 72
Ch. 9 Setting Up a Risk Management Department 88
Ch. 10 Understanding the Need for a Corporate Compliance Program 107
Ch. 11 Developing a Risk Management Manual 121
Ch. 12 Risk Management Program Development 130
Ch. 13 The Risk Manager's Responsibility for Off-Premises Locations 152
Ch. 14 Managing the Data Needs of Managed Care 164
Ch. 15 Education As a Valuable Risk Management Tool 182
Ch. 16 Consent Issues in the Medical Environment 190
Ch. 17 A Basic Insurance Primer 202
Ch. 18 Understanding Provider Excess and Stop-Loss Insurance 215
Ch. 19 Insurance Products To Minimize the Financial Risks of Managed Care 220
Ch. 20 Risk Financing: An Important Risk Management Function 232
Ch. 21 Risk Financing Issues Facing Medical Providers 245
Ch. 22 Guidelines for In-House Claims Management 253
Ch. 23 Risk Management Issues Associated with Anesthesia 266
Ch. 24 Developing a Comprehensive Risk Management Program in Obstetrics 280
Ch. 25 Risk Management Issues in the Emergency Department 295
Ch. 26 Risk Management in the Pediatric Setting 305
Ch. 27 Risk Management in the Psychiatric Setting 328
Ch. 28 Managing the Risks Associated with Clinical Research 341
Ch. 29 Managing the Risks Associated with Telemedicine 363
Ch. 30 Managing the Risks of Home Health Care 380
Ch. 31 Legal Issues Associated with the Use and Development of Practice Guidelines 384
Ch. 32 Managing the Risks of Workers' Compensation 399
Ch. 33 Credentialing Issues and Managed Care 414
Ch. 34 The Physician As Gatekeeper - What Are the Risks? 426
Ch. 35 Ethics, Accreditation, and Managed Care: A Guide for Risk Managers 435
Ch. 36 Legislative and Regulatory Issues 445
Ch. 37 COBRA Risks and Managed Care 461
Ch. 38 Managed Care Contracting 477
Index 503
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