Managed Care Contracting Services
Managed Care Services:
• Evaluation of managed care contract
• Evaluate services of the competition
• Isolate administrative issues
• Eliminate over-contracting
• Negotiation of contract terms
Fee Schedule Review:
• Evaluation of standard fee schedule of the practice
• Cost Based
• RBRVS
Comparison of Top Billed Codes:
• Comparison of practice fee schedule with the contractual reimbursement amounts of all contracted carriers and government plans
• Evaluate cost of contract, based on actual cost of procedure, and reimbursement
Audit of Insurance Payments:
• Audit payments to determine compliance with contract terms and fee schedule
• Identify problem contracts
The DoctorsManagement team has experience working in conjunction with the Physician Recruitment systems used by hospitals and private physician practices. We understand a quick turnaround is vital to a new practice, as well as when adding a new provider to an existing practice.
A critical step in achieving good reimbursement for the practice is signing good managed care contracts. Once a cost-based fee schedule is established for the practice, the reimbursement points for the contracts can be established.
DoctorsManagement will help the new provider office to create a cost-based fee schedule that is competitive in the marketplace and will easily translate to managed care and government reimbursement rates.
We will complete the provider enrollment applications and get the credentialing process started. While the provider is in credentialing, we will obtain copies of the contracts, perform a reimbursement analysis and negotiate the contract for more favorable contract terms and reimbursement.
|
|
 |
|
|
|
|
|
|
