The help managed care professionals have been looking for
Managed care contract terms have a direct impact on your organization’s bottom line, in terms of patient volume, revenue, and cash flow—not to mention staffing and business planning. Those contracts have a major effect on the profitability, and even the success or failure of your organization. So it’s crucial that you have a plan in place for your contracting and reimbursement strategy.
The Managed Care Contracting Survival Guide is here to help. It delivers what no other publication in the industry does—a current, complete "how-to" guidance to meet the myriad challenges inherent to managed care contracting.
The Managed Care Contracting Survival Guide gives you hands-on, practical, day-to-day tactics for successful business operations. You'll learn how to:
- recognize legal risks before they become compliance problems
- take the stress out of planning and running negotiation sessions
- develop reimbursement contracts that don't drain your organization's bottom line
- recognize legal risks before they become compliance problems
- solve key business issues, such as out-of-network, silent PPOs, pay for performance programs, and antitrust issues
It's time for this proactive guidance
Every healthcare professional knows that the day-to-day operations are as much a function of dealing with laws, regulations, price guidelines, and internal policies as is the desire to provide quality care. Nowhere else is the impact on the facility's bottom line more evident than in managed care contracting. It's noticeable in terms of patient volume, revenue, cash flow, staffing, and business planning. The contacts that a provider enters into or decides not to participate in have a major effect on the profitability, and even the success or failure of the organization.
The Managed Care Contracting Survival Guide will help you build a sound negotiating strategy, write guidance that sets realistic time lines, resolve disputes in your facility's favor, and most importantly, get paid what you deserve and on time.
Surveys confirm that the negotiating process is stressful and often intimidating for managed care professionals. Issues surrounding reimbursement and payer policies are among those most often cited as troublesome in terms of training staff.
The Managed Care Contracting Survival Guide breaks down these difficult and challenging concepts and offers realistic solutions that put you in control.
You'll find guidance on important topics such as:
- Basic negotiating strategies and current climate, including out of network, silent PPOs, prompt-pay laws
- Analysis of prompt-pay laws and how to stand up for timely reimbursement if state statue doesn't support the provider
- Conducting contract talks with pay-for-performance and quality-based reimbursement programs
A must-have resource for financial success The Managed Care Contracting Survival Guide is a must-have resource for managed care directors and their staff. If you are a PFS professional, contract modeler, revenue cycle manager, chief financial officer, or vice president of finance, order a copy of The Managed Care Contracting Survival Guide for your managed care staff and give them the inside edge they need for your organization's financial success.
Meet The Authors
Lisa Spoden, PhD, MHA, is senior partner and executive vice president of Strategic Health Care, in Washington, DC. Spoden oversees the company’s association management, federal grants, and managed care contracting practice areas, providing strategic guidance, program development, and executive management expertise.
John M. Kirsner, Esq. is partner with Squire, Sanders & Dempsey of Columbus, OH. Kirsner acts as both counsel and advocate for insurance companies, health plans, managed care organizations, hospitals, other health care providers and governmental organizations.
The HCPro Risk-Free, Money-Back Guarantee
If you are at all unhappy with your purchase, send it back within 30 days and you will receive a prompt, polite, 100% refund.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
