Top Managed Care Contracting Clauses: A Tool-kit for Providers

Front Cover
Robert Fisk
HC Pro, Inc., 2007 - Medical - 134 pages
As a provider, your survival hinges on your ability to maximize reimbursements from managed care contracts and control access to agreed-upon discounts. But money lost at the time of service or through the collection process is often determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated. Top Managed Care Contracting Clauses: A Toolkit for Providers contains practical strategies and tools for any organization facing the prospect of negotiating a new managed care contract.
 

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Contents

Copayments coinsurance and deductibles
1
Billing and claims
7
Ensuring prompt payment
21
Denials and claim adjustments
31
Dealing with outofnetwork and silent PPO issues
39
Limiting the frequency and scope of audits
55
Mediation arbitration and appeals
63
Controlling the products accessing your agreements
79
Transparency of pricing and quality information
95
Emergency preparedness
111
Miscellaneous clauses
117
How to use the files on your CDROM
131
Copyright

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