Healthcare organizations often handle managed care contracts that are intentionally difficult to understand, meaning hospitals make less money on them. Companies like Managed Care Consultants often handle these contracts, but it is still important to understand what they mean for your healthcare organization.
You Must Ask the Right Questions
When determining who will handle your managed care contracts, it is important to ask the right questions to ensure you choose the right business. While there are nearly 100 questions to consider and more than 20 categories in which they fit, some of the most important ones include how rate changes are handled, what the utilization-management structure will be, and how payment methods are defined.
You Must Use the Resources You Have Available
Choosing the proper company means knowing how to use the resources you have available. The American Medical Association provides a yearly National Managed Care Contract database. This database allows healthcare organizations to read any changes in the statutes and regulations of these contracts each year and provides answers a to a variety of questions resulting from those changes.
You Need to Train Your Revenue Cycle Team
Your revenue cycle team must be able to handle anything that comes at them. This means being persistent, understanding what need to be collected, and knowing how to be polite but aggressive when necessary. Managed care contracts are convoluted, easy to misunderstand, and easy to become frustrated with. Your team needs to be able to work well under stress and receive ongoing training as the regulations change each year.
When it comes to hiring a company to handle your managed care contracts, it is important to consider all your options. You want a company that is well-respected, has excellent reviews from current and former clients, and has the proper license and insurance to do business. (bfiweek) By choosing the right company, you ensure your healthcare organization is making the most money possible.
