1. Are incentives to use the PPO included in the health benefit design?
2. Are incentives to use the PPO greater than 10 percent?
3. Does the benefit plan accompany the contract to evaluate incentive package, non-covered services and plan competitiveness?
4. Are there outpatient or second surgical opinion requirements? If yes, are they reasonable?
More Articles on Managed Care Contracts:
4 Managed Care Negotiation Strategies for 2012
West Virginia Medicaid May Expand Managed Care
5 Managed Care Contract Questions Regarding Referral Requirements
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.