Top Managed Care Contracting Clauses
Robin J. Fisk, Esq.
Product Description:
Click here to listen to an interview with author Robin Fisk!
Don’t cost yourself money due to a contract technicality
Far too often, money lost at the time of service or through the collection process is determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated.
Sample language found in this comprehensive resource… no need to look anywhere else!
Minimize contractual ambiguities between you and your managed care partner by fortifying the document with language that protects you. Top Managed Care Contracting Clauses: A Tool-kit for Providers contains examples of contract clauses and letters to protect you when it matters most: at the time you get paid. Eliminate problematic language which could cost you money by modeling key portions of your contracts after the examples provided in this book.
Accompanying CD allows you to customize
Use the book version of Top Managed Care Contracting Clauses: A Tool-kit for Providers for quick reference, or use the accompanying CD, to download the language and customize it to your specific situation. You can simply search the topic or contract area you need, then copy, paste and edit to suit your needs.
Solutions for an abundance of tricky situations
This thorough reference book draws on the experience of health law attorney Robin Fisk, Esq., who has an extensive background representing providers, practitioners and managed care organizations in contract negotiations. The sample contract language covers such thorny issues as:
- Collecting on copayments, coinsurance and deductibles
- Billings and claims
- Overpayments/underpayments
- Pay for performance
- Out of network issues
- Audits
- Denials
- Mediation/arbitration/appeals
- Silent PPOs
With Top Managed Care Contracting Clauses: A Tool-kit for Providers, you will receive a comprehensive set of checklists, forms, letters and clauses, which you can customize to fit your specific situation. Take a look at the table of contents:
Chapter 1: Copayments, coinsurance, and deductibles
Chapter 2: Billing and claims
Chapter 3: Ensuring prompt payment
Chapter 4: Denials and claim adjustments
Chapter 5: Dealing with out-of-network and ‘silent PPO’ issues
Chapter 6: Limiting the frequency and scope of audits
Chapter 7: Mediation, arbitration, and appeals
Chapter 8: Controlling the products accessing your agreements
Chapter 9: Transparency of pricing and quality information
Chapter 10: Pricing and specific payment issues
Chapter 11: Emergency preparedness
Chapter 12: Miscellaneous clauses
Novices and experts alike will benefit from this invaluable information
Managed care directors, vice presidents of managed care, and contract managers for healthcare facilities will all benefit from the tools provided within Top Managed Care Contracting Clauses: A Tool-kit for Providers. You will learn how to phrase provisions for quickly and accurately resolving payment disputes, handling slow paying plans, and challenging claims denials or downgrades.
The HCPro Risk-Free, Money-Back Guarantee
If for any reason Top Managed Care Contracting Clauses: A Tool-kit for Providers does not meet your needs, return it within 30 days and you will receive a prompt, polite 100% refund… no questions asked.
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