The first ever book written in plain English explaining various functions of HMOs. What they are and how they work? This book is a treat for anyone who deals with an HMO. It tells about so many functions of an HMO organization. The book covers topics ranging from Prior Authorization, Concurrent Review, Case Management, Quality Management, Appeals Process, Physician Credentialing, Pharmacy Benefits and many more. The best part of the book is that at each step the book explains your (provider/physician) role in helping your HMO patients get the best quality care with minimal utilization of your resources – your time, nursing and clerical staff of your practice. It also tells.
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