Don’t be intimidated by the thought of negotiating managed care contracts.
Learn how to get the terms—and payment—your organization deserves.
Negotiating contracts for managed care reimbursement is a significant challenge for healthcare providers. Even if you have experience at the negotiating table, it can be tough to get the terms and payment your organization deserves for the care it provides.
Beyond the Contract: Managing your relationship with a healthcare payer is a hands-on survival guide that helps you prepare for negotiating sessions by delivering techniques and strategies you need so your organization comes out of contract talks on the winning end. Learn how to go further to protect your revenue under the contract terms that you have negotiated.
Who is in charge of your managed care contract? You or the plan?
Many books focus on the contents of the managed care contract. While the terms in the contract document are very important to the quality of your relationship with a managed care plan, they are only part of the story. You need to be able to manage your relationship with the plan on a day-to-day basis.
Ask yourself these three questions
- How do you effectively communicate with the plan to prevent little issues from growing into large, expensive ones?
- How do you command the plan’s attention and get them to respond in a timely way?
- How do you avoid re-submitting your complaint or dialing from person to person trying to get answers?
When the working relationship between the plan and the health care provider functions well, you save time, staff resources and headaches. By monitoring and insisting on your rights at every turn, you also create an incentive for how you expect—and need—the plan to behave.
Solid advice from industry experts
Beyond the Contract draws on a variety of articles and tools published in HCPro’s Managed Care Contracting & Reimbursement Advisor, its leading monthly newsletter dedicated to advising health care providers on optimizing their health plan relationships.
The editorial team gathered advice from sources who are experts at managing relationships between plans and providers. You’ll benefit from their experience by learning how to recognize issues you face in your daily operations and scenarios you’ll encounter at the negotiating table. You’ll learn how to make sound decisions and take proactive steps to respond to—and manage—the plan.
The accompanying CD-ROM comes with examples of contract clauses, model contracts, and relevant sample language you can download and customize for your organization, and a multi-page checklist for negotiation success. Each of these tools will be a valuable addition to your contract negotiations toolkit.
Beyond the Contract is a must-have resource for:
- Managed care directors
- PFS managers
- CFO’s and VP’s of finance
- Medical group administrators
It's a great resource for everyone responsible for monitoring managed care contracts.
Manage the plan—but don’t be intimidated by it
Take control with the strategies and techniques in Beyond the Contract: Managing Your Relationship with a healthcare payer. As always, your purchase is covered by HCPro's 30-day money back guarantee. If you're not happy, just send it back and we'll refund your purchase price.
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