HIPAA Security Implementation
(PDF, 199KB)

First State Orthopaedics v. Concentra:
Concentra Settlement Opt-Out Instructions
(PDF, 19KB)

2007 Update Competition in Health Insurance: A Comprehensive Study of US Markets

Optimizing outcomes and pay for performance:Can patient registries help?

Click and Complain

Activities in the private sector

Hot issues concerning physician profiling

CME Video for Physicians: "Understanding Episodes of Care"
Visit the North Carolina Medical Society Web site to view the above video produced by the Physicians Advocacy Institute, Inc. that could earn you CME credit. This link will take you off the AMA Web site. The AMA is not responsible for the content of other Web sites.

How to Challenge Your Profile or Placement in a Tiered or Narrow Network and Physician profiling: How to prepare your practice

Had It with Unfair/Inaccurate Physician Profiling and Ratings?
Let your patients know with this free AMA poster.

New York Attorney General announces agreements with insurers on doctor ranking programs

BCBS interactive settlement map now available

Three Rivers Provider Network Physician Solicitation

When to Call Private Sector Advocacy (PDF, 149KB)

PSA tools and publications

Tools and publications developed for physicians and their staff

Practice Management Center

The PMC provides physicians and their staff with a number of educational tools and resources to address private payer and practice management issues.

Defensible Fee Schedule Toolkit

The AMA's Practice Management Center (PMC) has developed resources to help physicians and their practice staff in establishing defensible fee schedules.

Toolkit for Out-of-network services

The AMA's Practice Management Center (PMC) has developed resources to help physicians and their practice staff in dealing with payments for out-of-network services.

Antitrust relief is a top priority of the AMA. In addition to our advocacy efforts with legislators and regulators, the AMA also works to educate physicians about the realities of the current antitrust environment. Access antitrust educational tools and learn about AMA advocacy efforts on this issue.

Medicare Advantage

There have been many changes to Medicare's managed care program as a result of the passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which will mean more choices for patients - and more questions for physicians.

Pay for performance/Physician reimbursement methodologies

A variety of resources related to pay for performance and profiling of physicians on cost of care.

Managed care contracting

AMA's 2005 Revised Model Managed Care Contract is now available. The contract, along with other available tools, plays an important role in the AMA's efforts to challenge the unfair and one-sided contracts physicians typically receive on a take-it-or-leave-it basis.

HIPAA and health plan complaint forms

Recent modifications to both forms reflect changes in the marketplace, as well as the greater level of complexity that has been introduced into the physician practice.

AMA Testimony to NAIC and NCOIL

Prompt payment/payment hassles

Learn about the AMA's aggressive efforts to combat delayed payment of claims and other payment hassles and what physicians can do to protect themselves from these practices.

Claims processing

The AMA offers a number of practical tools to help physicians and their staff manage the claims process and appeal claims that are inappropriately denied.

Health Plan Settlements

Information on the Multi-District Litigation and Blue Cross and Blue Shield settlements.

Managed care markets

Read about the AMA study, Competition in Health Insurance: A Comprehensive Study of US Markets, which shows that many health insurance markets around the country are dominated by one or two insurers. Learn why the AMA is concerned about the long-term impact of these market dynamics.