The keys to successful managed care contracting

Managed care contracting is no simple process. Healthcare providers are tasked with negotiating optimal contracts, modeling the contract’s impact on revenue, ensuring payers uphold their end of contracts and handling payment disputes.

Advertisement

 

Because of the intricacy of managed care contracts, many healthcare providers have not closely analyzed terms for quite some time, oftentimes leading to a significant loss in revenue. Managed care contracting may be a tortuous process, but understanding a few key points can result in increasing a provider’s bottom line. Essential managed care contracting concepts include:
 
• Knowledge of procedure logic and claim adjudication
• Understanding of implant language and billing requirements
• Grasp of general contract language and renegotiation

Learn more about the ins and outs of managed care contracting during a webinar hosted by National Medical Billing Services and Becker’s Hospital Review on Oct. 14 10:30 AM to 11:30 AM CT. Click here to register.

More articles on finance issues:
Lifetime of healthcare costs up 11% in one year, study shows
RCM tip of the day: Add consent for communication preferences to patient-facing materials
The most expensive US cities for 7 common medical procedures

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.