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| carelon medical benefits management: Let's Go! Jamie Ramsden, 2024-05-14 Ever noticed how leadership theories can disintegrate in the face of real-world challenges? That’s frustrating, whether you’re a busy executive or a developing leader. On the other hand, purely reactive problem-solving is like bailing water from a ship without ever patching the leaks. With no reflection, no structure, no guiding vision, your temporary fixes won’t last, and soon you’re bailing water again. Author Jamie Ramsden has thrived in the leadership world as a successful executive, an elite coach, and an academic. <i>Let’s Go!</i> lays out his own powerful leadership framework, which merges hands-on business knowledge with profound insights into human motivations. The effective leader is a role model, a community builder, a sense maker, and a future shaper. In this inspirational book, Jamie blends theory and practical application to show you how to excel in each of these four leadership roles—and bring your team, your family, and your whole community along for the ride. <i>Let’s Go!</i> empowers executives and leaders to elevate their game, better understand themselves and their world, and live to their fullest potential—not for a few months or even a few years, but forever. |
| carelon medical benefits management: Dear Physician , 1994 |
| carelon medical benefits management: New York State Service New York (State). Department of Civil Service, 1887 |
| carelon medical benefits management: Definition of Serious and Complex Medical Conditions Institute of Medicine, Committee on Serious and Complex Medical Conditions, 1999-10-19 In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients. |
| carelon medical benefits management: Perinatal Intensive Care Silvio Aladjem, Audrey K. Brown, 1977 |
| carelon medical benefits management: Annual Quality Plan United States. Internal Revenue Service. Assistant Commissioner (Procurement), 1992 |
| carelon medical benefits management: Forced to Care Evelyn Nakano Glenn, 2010-06-15 Scouring the history of Native American boarding schools, nineteenth-century reformatories, and programs to Americanize immigrants, Glenn brilliantly reveals the role of coercion in caregiving. An important read for us all.---Arlie Hochschild, author of The Time Bind -- |
| carelon medical benefits management: Phoenix Zones Hope Ferdowsian, 2018-04-06 Few things get our compassion flowing like the sight of suffering. But our response is often shaped by our ability to empathize with others. Some people respond to the suffering of only humans or to one person’s plight more than another’s. Others react more strongly to the suffering of an animal. These divergent realities can be troubling—but they are also a reminder that trauma and suffering are endured by all beings, and we can learn lessons about their aftermath, even across species. With Phoenix Zones, Dr. Hope Ferdowsian shows us how. Ferdowsian has spent years traveling the world to work with people and animals who have endured trauma—war, abuse, displacement. Here, she combines compelling stories of survivors with the latest science on resilience to help us understand the link between violence against people and animals and the biological foundations of recovery, peace, and hope. Taking us to the sanctuaries that give the book its title, she reveals how the injured can heal and thrive if we attend to key principles: respect for liberty and sovereignty, a commitment to love and tolerance, the promotion of justice, and a fundamental belief that each individual possesses dignity. Courageous tales show us how: stories of combat veterans and wolves recovering together at a California refuge, Congolese women thriving in one of the most dangerous places on earth, abused chimpanzees finding peace in a Washington sanctuary, and refugees seeking care at Ferdowsian’s own medical clinic. These are not easy stories. Suffering is real, and recovery is hard. But resilience is real, too, and Phoenix Zones shows how we can foster it. It reveals how both people and animals deserve a chance to live up to their full potential—and how such a view could inspire solutions to some of the greatest challenges of our time. |
| carelon medical benefits management: Behavioral Neurology & Neuropsychiatry David B. Arciniegas, C. Alan Anderson, Christopher M. Filley, 2013-01-24 The merger of behavioral neurology and neuropsychiatry into a single medical subspecialty, Behavioral Neurology & Neuropsychiatry, requires an understanding of brain-behavior relationships and a clinical approach that transcends the traditional perspectives of neurology and psychiatry. Designed as a primer of concepts and principles, and authored by a multidisciplinary group of internationally known clinical neuroscientists, this book divides into three sections: • Structural and Functional Neuroanatomy (Section I) addresses the neuroanatomy and phenomenology of cognition, emotion, and behavior • Clinical Assessment (Section II) describes neuropsychiatric history taking, neurological and mental status examinations, neuropsychological assessment, and neuroimaging, electrophysiologic, and laboratory methods • Treatment (Section III) discusses environmental, behavioral, rehabilitative, psychological, social, pharmacological, and procedural interventions for cognitive, emotional, and behavioral disorders. By emphasizing the principles of Behavioral Neurology & Neuropsychiatry, this book will improve your understanding of brain-behavior relationships and inform your care of patients and families affected by neurobehavioral disorders. |
| carelon medical benefits management: Sober For Good Anne M. Fletcher, 2002-04-17 Finally someone has gone straight to the real experts: hundreds of men and women who have resolved a drinking problem. The best-selling author Anne M. Fletcher asked them a simple question: how did you do it? The result is the first completely unbiased guide for problem drinkers, one that shatters long-held assumptions about alcohol recovery. Myth: AA is the only way to get sober. Reality: More than half the people Fletcher surveyed recovered without AA. Myth: You can't get sober on your own. Reality: Many people got sober by themselves. Myth: One drink inevitably leads right back to the bottle. Reality: A small number of people find they can have an occasional drink. Myth: There's nothing you can do for someone with a drinking problem until he or she is ready. Reality: Family and friends can make a big difference if they know how to help. Weaving together the success stories of ordinary people and the latest scientific research on the subject, Fletcher uncovers a vital truth: no single path to sobriety is right for every individual. There are many ways to get sober - and stay sober. SOBER FOR GOOD is for anyone who has ever struggled not to drink, coped with someone who has a drinking problem, or secretly wondered, Do I drink too much? |
| carelon medical benefits management: American Psychiatric Association Practice Guidelines American Psychiatric Association, 1996 The aim of the American Psychiatric Association Practice Guideline series is to improve patient care. Guidelines provide a comprehensive synthesis of all available information relevant to the clinical topic. Practice guidelines can be vehicles for educating psychiatrists, other medical and mental health professionals, and the general public about appropriate and inappropriate treatments. The series also will identify those areas in which critical information is lacking and in which research could be expected to improve clinical decisions. The Practice Guidelines are also designed to help those charged with overseeing the utilization and reimbursement of psychiatric services to develop more scientifically based and clinically sensitive criteria. |
| carelon medical benefits management: Algorithms and Law Martin Ebers, Susana Navas, 2020-07-23 Exploring issues from big-data to robotics, this volume is the first to comprehensively examine the regulatory implications of AI technology. |
| carelon medical benefits management: ICD-10-CM Official Guidelines for Coding and Reporting - FY 2021 (October 1, 2020 - September 30, 2021) Department Of Health And Human Services, 2020-09-06 These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated. |
| carelon medical benefits management: Inside Rehab Anne M. Fletcher, 2013-02-07 An eye-opening tour of the addiction treatment industry explores the gap between what should happen and what does What happens inside drug and alcohol rehabilitation centers and how rehab works are a mystery to those outside the industry – and sometimes even to those inside it. Anne M. Fletcher is a trusted New York Times bestselling health and medical writer who visited 15 addiction treatment centers—from outpatient programs for the indigent to famous celebrity rehabs; from the sites of renowned Twelve-Step centers to several unconventional programs—to find out what really happens. What she reveals ranges from inspirational to irresponsible, and, in some cases, potentially dangerous. Real Stories: As always with her books, Fletcher gets the inside story by turning to real people who “have been there,” interviewing more than 100 individuals whose compelling stories illustrate serious issues facing people in rehab and endemic in the rehab industry today. Connected Writer and Researcher who has earned the respect (and cooperation) of experts throughout the fields she’s taken on. Inside Rehab is no exception—Fletcher has interviewed more than 100 professionals working in the field, including a mix of rehab staffers and administrators as well as leading academics. Rehab is constantly covered in the media, as celebrities battle their drug and alcohol issues in the spotlight and reality TV puts recovery in prime time. Addiction is no longer only a personal struggle—it’s a pop culture phenomenon. Myth Busting: Fletcher exposes twelve supposed facts for the falsehoods they are, including “rehab is necessary for most people to recover from addictions;” “highly trained professionals provide most of the treatment in addiction programs;” and “drugs should not be used to treat a drug addict.” Fletcher’s most important finding is the alarming discrepancy between the treatments being employed at many rehab centers and the treatments recommended by leading experts and supported by scientific research. Guidance and Practical Solutions: Inside Rehab also highlights what is working, spotlights state-of-the-art programs and practices, and offers advice and guidance for people seeking quality care and treatment for themselves or those they care about. Inside Rehab is the first book to give readers a thoughtful, sensitive, and bracingly honest insider’s view of the drug and alcohol rehab industry in America. For people seeking quality care for themselves or a loved one, Inside Rehab is essential reading, offering a wealth of accurate information and wise guidance. |
| carelon medical benefits management: Actuarial Exam Tactics Mike Jennings, Roy Ju, 2017 |
| carelon medical benefits management: The Signals Are Talking Amy Webb, 2016-12-06 Amy Webb is a noted futurist who combines curiosity, skepticism, colorful storytelling, and deeply reported, real-world analysis in this essential book for understanding the future. The Signals Are Talking reveals a systemic way of evaluating new ideas bubbling up on the horizon-distinguishing what is a real trend from the merely trendy. This book helps us hear which signals are talking sense, and which are simply nonsense, so that we might know today what developments-especially those seemingly random ideas at the fringe as they converge and begin to move toward the mainstream-that have long-term consequence for tomorrow. With the methodology developed in The Signals Are Talking, we learn how to think like a futurist and answer vitally important questions: How will a technology-like artificial intelligence, machine learning, self-driving cars, biohacking, bots, and the Internet of Things-affect us personally? How will it impact our businesses and workplaces? How will it eventually change the way we live, work, play, and think-and how should we prepare for it now? Most importantly, Webb persuasively shows that the future isn't something that happens to us passively. Instead, she allows us to see ahead so that we may forecast what's to come-challenging us to create our own preferred futures. |
| carelon medical benefits management: Collaborative Practice in Primary and Community Care Sanjiv Ahluwalia, John Spicer, Karen Storey, 2019-07-23 The effective delivery of primary care requires the good working of a multi-professional team who provide that care. This accessible and concise text explores the ways in which primary care teams can collaborate well to advance the quality of clinical care and enhance collaborative working across the healthcare system as a whole. Taking a workbook approach, and including examples, narratives, case histories and further reading, Collaborative Practice in Primary and Community Care brings together theory and good practice to offer the reader viable models for achieving excellence. Addressing specific challenges to practising collaboratively throughout, it contains chapters exploring the contemporary context of primary care, collaboration with patients, collaboration between different professional groups, collaboration amongst organisations, and the respective roles of education and technology in promoting collaboration. Written by a multi-professional selection of experienced authors, practitioners and educators, this textbook is designed for a wide audience of healthcare professionals with an interest in primary care. |
| carelon medical benefits management: CDT 2021 American Dental Association, 2020-09-08 To find the most current and correct codes, dentists and their dental teams can trust CDT 2021: Current Dental Terminology, developed by the ADA, the official source for CDT codes. 2021 code changes include 28 new codes, 7 revised codes, and 4 deleted codes. CDT 2021 contains new codes for counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use, including vaping; medicament application for the prevention of caries; image captures done through teledentistry by a licensed practitioner to forward to another dentist for interpretation; testing to identify patients who may be infected with SARS-CoV-2 (aka COVID-19). CDT codes are developed by the ADA and are the only HIPAA-recognized code set for dentistry. CDT 2021 codes go into effect on January 1, 2021. -- American Dental Association |
| carelon medical benefits management: Community Nursing and Primary Healthcare in Twentieth-Century Britain Helen M. Sweet, with Rona Dougall, 2007-12-12 This book looks at community nursing history in Great Britain during the twentieth century to examine the significant changes affecting the nurse’s work on the district including compulsory registration for general nursing, changes in organisation, training, conditions of service and workload. |
| carelon medical benefits management: Moodswing Ronald R. Fieve, 1989-01-01 Discusses the causes of depression, looks at its connections with alcohol and drug abuse, and explains modern treatment procedures |
| carelon medical benefits management: The Affordable Care Act Tamara Thompson, 2014-12-02 The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout. |
| carelon medical benefits management: Essentials of Managed Health Care Peter Reid Kongstvedt, 2003 |
| carelon medical benefits management: Reasonable Rx Stan N. Finkelstein, Peter Temin, 2008 Explores the problem of high drug prices by taking a close look at the science of drug development, how the drug industry operates, how new drugs are discovered, and how the government affects and controls these processes. By examining recent changes in the pharmaceutical industry in more depth, the authors explain how more radical changes can both reduce prices and improve the flow of new drugs. |
| carelon medical benefits management: Alcoholics Anonymous Bill W., 2014-09-04 A 75th anniversary e-book version of the most important and practical self-help book ever written, Alcoholics Anonymous. Here is a special deluxe edition of a book that has changed millions of lives and launched the modern recovery movement: Alcoholics Anonymous. This edition not only reproduces the original 1939 text of Alcoholics Anonymous, but as a special bonus features the complete 1941 Saturday Evening Post article “Alcoholics Anonymous” by journalist Jack Alexander, which, at the time, did as much as the book itself to introduce millions of seekers to AA’s program. Alcoholics Anonymous has touched and transformed myriad lives, and finally appears in a volume that honors its posterity and impact. |
| carelon medical benefits management: The Attachment Bond Virginia M. Shiller, 2017-01-17 The Attachment Bond: Affectional Ties across the Lifespan draws together and evaluates the vast body of research on the causes and consequences of attachment security in infants, growing children, and adults. Reviewing and synthesizing the results of five decades of attachment theory and research in the fields of developmental, clinical, and social and personality psychology, Virginia M. Shiller succinctly summarizes the most important findings regarding the significance of early as well as ongoing security in attachment relationships. Conclusions from studies conducted around the globe inform the reader of the impact of relational experiences in childhood, adolescence, and adulthood on the social, emotional, and physical well-being of individuals. |
| carelon medical benefits management: How to Thrive in Counseling Private Practice Anthony Centore, Anthony Centore Ph D, 2016-07-25 Are you looking to start, build or grow a counseling private practice? Are you wanting to get off the ground, open your doors, or build a caseload of clients? Are you confused about networking, marketing, licensing, networking, billing or other practice management issues that you never even heard of when you were in grad school? Are you thinking about converting a successful solo practice into a larger group or agency? In this work, Dr. Anthony Centore (Licensed Counselor, Private Practice Consultant for the American Counseling Association, and CEO of Thriveworks) shares road-tested practice building strategies from his direct, extensive, experience growing a successful chain of mental health counseling practices. A must have resource for anyone getting started, or working to grow, a coaching or counseling practice. |
| carelon medical benefits management: You and AI Rajeev Ronanki, 2021-11-09 THE HEALTHCARE INDUSTRY HAS PROBLEMS. EXPONENTIAL TECHNOLOGIES ARE THE ANWSER. Exponential technologies are transforming our present and shaping the future. The leading companies of today--and tomorrow--are those that make innovative exponential technologies central to their business practices and strategy. In You and AI, author Rajeev Ronanki explores how exponential technologies can solve the problems that plague the American healthcare industry and provide everyone better, personalized healthcare at lower cost. Enterprising healthcare companies like Anthem are forging the way by integrating exponential technologies right into the company DNA, creating AI-first, blockchain-first, data-first, technology-first digital enterprises for the twenty-first century and beyond. |
| carelon medical benefits management: The Couples Manual Azita Abtin, Dr., Dr Azita Abtin Psy D, 2013-12 A therapy guide for marriage, couples and other relationships. Dr. Azita Abtin addresses the factors, attitudes and behaviors that strengthen relational bonds and identifies self sabotaging thoughts, feelings and behavior that prevent the development of a win-win relationship. Dr. Abtin assists couples in developing better insights to themselves and their partners in order to strengthen their union, through knowledge of the underlying values and dynamics of healthy versus unhealthy relationships. This manual addresses communication issues, defense mechanisms and other dysfunctional patterns, and therapy sabotaging behaviors to help others enrich their marital or couple relationships. |
| carelon medical benefits management: Mental Health Through Education Will Carson Ryan, 1938 |
| carelon medical benefits management: Should I Stay Or Go? Lee Raffel, 1999 Until now, couples facing the dilemma of deciding whether or not to stay in an unhappy marriage had three options: individual or couples therapy, separation, or divorce. Should I Stay or Go? provides these couples with a fourth option--the Controlled Separation (CS). CS is a compassionate process that is designed to build respect and foster advocacy between spouses. The book explains the CS guidelines, including the 12 fundamental issues that must be resolved for a workable, orderly separation. It also contains sample contracts, along with helpful checklists and self-assessment tools. |
| carelon medical benefits management: Adolescent Schizophrenia James T. Nillinghouse, Robert P. Trotman, 2009 Schizophrenia is a chronic disorder that impacts a broad range of a person's social and developmental functioning. Until the recent past, most of the research done on schizophrenia did not include children or adolescents who suffer from the disorder. During adolescence, important changes take place in brain development. These changes make adolescence a period of both vulnerability and opportunity. Emergence of psychosis and schizophrenia may be associated with abnormal brain development during adolescence. This book discusses the findings of studies that focus on abnormal brain development during the premorbid period of psychosis and schizophrenia. Cognitive neuroscience constructs of visuospatial memory and working memory are associated with adult- and adolescent-onset schizophrenia. This book reviews the existing literature on the topic and explores the nature of and association between visuospatial memory in adolescent onset schizophrenia. The prevalence of psychotic symptoms in the general population, particularly in children and adolescents, is also explored. The significance of psychotic symptoms in relation to psychiatric disorders, such as depression and anxiety, and its relation to social factors, such as childhood abuse is examined. To deal with schizophrenic young patients in a hospital, psychoanalytical psychotherapeutic teamwork is reviewed. The transference relation between patient and therapist, and what it entails, is also discussed. |
| carelon medical benefits management: Treatment of Autism Spectrum Disorder , 2021-06 The new edition of this practical accessible text introduces preservice SLPs to 12 evidence-based interventions that improve the communication and social skills of people with autism spectrum disorder-- |
| carelon medical benefits management: The Hospice Guide to Billing and Reimbursement Casey Fenton, Catherine Stapleton, 2016-07-21 The Hospice Guide to Billing and Reimbursement: Durable Guidance and Strategy for a Shifting Payment Landscape Casey Grimes Catherine Stapleton, MS The industrywide march toward standardized performance measurement and unified value-based payment structures requires hospice agencies to stay on top of CMS regulatory guidance. The Hospice Guide to Billing and Reimbursementis your comprehensive solution to implementing accurate, compliant, and competent billing practices at your organization. This book will help you provide the best training possible to your administrative staff and those who impact billing, increasing their competence and confidence about billing requirements and practices. It will equip providers with the broad frameworks and processes needed to develop billing systems and financial plans that meet CMS ever-sharper scrutiny. This book will help you understand: Regulators expectations surrounding billing and reimbursement for the Medicare hospice benefitRecent updates to payment terms, such as the introduction of the Service Intensity Add-on (SIA) and the two-tiered reimbursement structure for the provision of routine homecareWhat you need to do to prepare for the major changes still ahead (e.g., value-based purchasing models)How not to leave money on the table or be penalized unnecessarily Table of Contents: Today s Hospice Reimbursement and Billing Landscape at a GlanceOverview of the Medicare hospice benefitFoundations of hospice billing and reimbursementKey developments in recent yearsLarge-scale changes on the horizonLinking Hospice Philosophy, Care Practices and Outcomes, Operational Processes, and Received PaymentPromoting Ongoing Compliance With Long-Standing Components of Hospice Payment and BillingHonoring patient eligibility requirementsUnderstanding sequential billingDistributing Medicare coverage noticesCreating effective cost reportsResponding to additional development requests (ADR)Withstanding auditsAdapting Practices and Processes to Accommodate Recent, Industrywide Payment Rate and Process ChangesThe SIA and two-tiered RHC payment model introduced through 2016 rulemakingRecent adjustment to hospice caps calculation methodologyIntegrating the hospice PEPPER report (including recently updated coverage areas) into internal billing compliance initiativesAdhering to quality reporting expectations to avoid payment penaltiesPromoting timely filing of election notices and recertifications, as well as timely completion of face-to-face documentationCurbing high rates of recertification and revocationImplementing effective compliance strategies surrounding the launch of ICD-10 and general coding-related practices (including clinical documentation) that can influence paymentRecognizing and Readying Internal Systems for the Prospective Impact of Continuumwide Payment Reform InitiativesValue-based purchasingBundled paymentsAccountable care organizations (ACO)Implementing Enduring Billing Best Practices, Strategies, and Systems to Facilitate the Receipt of Deserved ReimbursementComplying with setting-specific guidelines, rules, and regulations, especially those governing hospitals, skilled nursing facilities, and assisted living facilitiesDeveloping effective initial and ongoing staff training |
| carelon medical benefits management: Michelle's Law United States. Congress. House. Committee on Energy and Commerce, 2008 |
| carelon medical benefits management: Building Recommendation Engines Sureshkumar Gorakala, 2016-12-30 Understand your data and preferences to make intelligent, accurate, and profitable decisionsAbout This Book* A step-by-step guide to building recommendation engines that are personalized, scalable, and real time* Get to grips with the best tool available on the market to create recommender systems* This hands-on guide shows you how to implement different tools for recommendation engines, and when to use whichWho This Book Is ForThis book caters to beginners and experienced data scientists looking to understand and build complex predictive decision-making systems, recommendation engines using R, Python, Spark, Neo4j, and Hadoop.What you will learn* Building your first recommendation engine* Discover the tools needed to build recommendation engines* Dive into the various techniques of recommender systems such as collaborative, content-based, and cross-recommendations* Familiarize yourself with machine learning algorithms in different frameworks* Build different versions of recommendation engines from practical code examplesIn DetailA recommendation engine (sometimes referred to as a recommender system) is a tool that lets algorithm developers predict what a user may or may not like among a list of given items. Recommender systems have become extremely common in recent years, and are applied in a variety of applications. The most popular ones are movies, music, news, books, research articles, search queries, social tags, and products in general.If you want to build efficient decision-making systems that will ease your work, this book is for you. This guide will take you on a unique journey of exploring various recommender systems, building them, and implementing them in popular techniques such as R, Python, Spark, and others. This book will cover all that is required to get you up and running with building recommender systems.The book starts with an introduction to recommendation systems and its applications. Then you will start building recommendation engines. As you move along, you will learn to build recommender systems with popular frameworks such as R, Python, Spark, Neo4j, and Hadoop with practical examples. You will get an insight into the pros and cons of each recommendation engine and when to use which recommendation. During the course of the book, you will create simple recommendation engine, real-time recommendation engine, scalable recommendation engine, and so on. You will familiarize yourselves with various techniques of recommender systems such as collaborative, content-based, and cross-recommendations before getting to know the best practices of building a recommender system towards the end of the book. |
| carelon medical benefits management: Employee Benefits and the New Health Care Landscape Alan Cohen, 2017-09-15 2018 International Book Awards Finalist in Business and Management Category We shop for everything else online...why not benefits? Using private benefit exchanges (a.k.a. “online benefits marketplaces”), employers can bring a consumer-centric online shopping experience to benefits. Alan Cohen, a benefits technology pioneer, details how these platforms can offer unprecedented flexibility and choice to employees, revolutionize the way employers attract and retain talent, strengthen cost control in an era of skyrocketing premiums, and promote much-needed innovation in the U.S. health care system. Discover How To Make sense of today’s challenging benefits landscape and plan breakthrough changes that have succeeded for thousands of employers of all sizes Leverage the lessons of the online shopping revolution to drive radical innovation Incorporate the 7 key pillars of a true private benefits exchange into your benefits mindset Gain indispensable practical insights from early adopters’ experiences Clarify the new roles of employers, HR, insurers, brokers, employees, and other stakeholders Accelerate your transition away from inefficient employer-managed plans Assess the ongoing impact of health care reform, public exchanges, health care consumerism, and other trends Alan Cohen created one of the first private exchange platforms and has pioneered this approach for more than a decade. Now, in a candid discussion of how the economic principles of choice, consumerism, and defined contribution are at work in an exchange environment, he breaks down the concept for HR professionals, entrepreneurs, brokers, insurers, health care reformers, policy makers, and employees. Cohen looks to social and economic implications to forge a future in which all eyes are on a new model of the consumer for the benefits age. With insights from industry veterans, Employee Benefits and the New Health Care Landscape brings a fresh perspective to the debate on health care and health insurance in America. |
Carelon MBM provider portal
Log in to the Carelon MBM Provider Portal (formerly AIM provider portal) to submit a new case for prior authorization or check the status of an existing case.
Log In or Register | Carelon
Our provider portal provides convenient tools and resources for processing claims, obtaining claims information, verifying eligibility status, and more. ProviderConnect. Our secure online …
Official Carelon Healthcare Services | Carelon
Carelon is a healthcare services company dedicated to delivering whole-person care with connected healthcare solutions for better outcomes and experiences.
Carelon Behavioral Health of Maryland
Carelon administers the Maryland PBHS in accordance with regulations set by the Maryland Department of Health (MDH). We manage specialty behavioral health services funded by …
For Providers - Carelon Health
For more than 30 years, we’ve been a leader in providing whole-person care to patients with Original Medicare, Medicare Advantage, Medicaid, or group and private health plans. Our care …
Carelon Provider Portals and Resources | Carelon - Carelon Insights
Access your Carelon provider portal, Carelon provider phone number, and additional resources to help you care for your patients.
Contact Us | Carelon Health
Call our patient support line at 844.998.3753. Support is available 8 a.m to 5 p.m. local time. After hours support for Primary Care patients will be directed to the Carelon Health Nurse Help Line. …
5 Ways Carelon Behavioral Providers Improve Mental Health Care
May 5, 2025 · Carelon Behavioral Providers offer comprehensive mental health services, including counseling, therapy, and support groups. Our network of behavioral health …
Carelon Health - Wikipedia
Carelon Health, (formerly CareMore) a subsidiary of Elevance Health through its Carelon brand, is an integrated health plan and care delivery system for Medicare and Medicaid patients.
About Carelon Healthcare Services | Carelon
With capabilities spanning pharmacy, behavioral health, palliative care delivery, medical benefits management, payment integrity, care navigation, research, and operations and technology …
Carelon MBM provider portal
Log in to the Carelon MBM Provider Portal (formerly AIM provider portal) to submit a new case for prior authorization or check the status of an existing case.
Log In or Register | Carelon
Our provider portal provides convenient tools and resources for processing claims, obtaining claims information, verifying eligibility status, and more. ProviderConnect. Our secure online …
Official Carelon Healthcare Services | Carelon
Carelon is a healthcare services company dedicated to delivering whole-person care with connected healthcare solutions for better outcomes and experiences.
Carelon Behavioral Health of Maryland
Carelon administers the Maryland PBHS in accordance with regulations set by the Maryland Department of Health (MDH). We manage specialty behavioral health services funded by …
For Providers - Carelon Health
For more than 30 years, we’ve been a leader in providing whole-person care to patients with Original Medicare, Medicare Advantage, Medicaid, or group and private health plans. Our care …
Carelon Provider Portals and Resources | Carelon - Carelon Insights
Access your Carelon provider portal, Carelon provider phone number, and additional resources to help you care for your patients.
Contact Us | Carelon Health
Call our patient support line at 844.998.3753. Support is available 8 a.m to 5 p.m. local time. After hours support for Primary Care patients will be directed to the Carelon Health Nurse Help Line. …
5 Ways Carelon Behavioral Providers Improve Mental Health Care
May 5, 2025 · Carelon Behavioral Providers offer comprehensive mental health services, including counseling, therapy, and support groups. Our network of behavioral health …
Carelon Health - Wikipedia
Carelon Health, (formerly CareMore) a subsidiary of Elevance Health through its Carelon brand, is an integrated health plan and care delivery system for Medicare and Medicaid patients.
About Carelon Healthcare Services | Carelon
With capabilities spanning pharmacy, behavioral health, palliative care delivery, medical benefits management, payment integrity, care navigation, research, and operations and technology …
