HCPro.com: Managed Care Contracting and Reimbursement Advisor

Managed Care Contracting & Reimbursement Advisor tells you exactly what you must know and do to successfully negotiate the best deal with HMOs, PPOs, and other payors - and get bigger and faster reimbursement!

To view the entire newsletter issue, click the “View Entire Issue” link below

October 2008 (Volume 5, Issue 10)	view entire issue

Use retail clinic referrals to boost your bottom line
Wal-Mart, CVS, Walgreens, and Kroger now have more than their friendly pharmacists in common. All have made forays into retail healthcare clinics.

E-visit payment promising but not ready for prime time
Payers are recognizing the power of the Internet. In December 2007, Hartford, CT–based Aetna expanded its relationship with RelayHealth, an Atlanta-based provider of Web-based communication services between physicians and patients, to allow physicians in more than 30 medical specialties who participate in most of Aetna’s fully insured plans to be reimbursed for RelayHealth webVisit consultations. The clinically structured online interviews allow patients to report nonurgent symptoms to physicians for quick responses without an office visit. Previously, only primary care physicians in California, Florida, and Washington had access to the online service.

Other recently-published articles from Managed Care Contracting and Reimbursement Advisor:

Use lean cost accounting to examine your cost structure

Bridges to Excellence pays bonuses to docs for implementing medical home

Ensure that contracts cover real-time claims adjudication

Build a defensible fee schedule to challenge lowball payer contracts

Use retail clinic referrals to boost your bottom line

E-visit payment promising but not ready for prime time

Think twice before opting out of Medicare

Prepare for contracting challenges during mergers, consolidations

E-tool: Sample letter to payer on intention to renegotiate

E-tool: Payer/MCO contract provision samples

Watch your contracts in the wake of ’final’ Stark rules

Put these provisions on your managed care contracting hot list

Audit your patient financial services department to maximize your managed care reimbursement

Push the envelope when contracting with highly scrutinized payers

Case study: Go electronic on your charge capture process

ABOUT HCPRO

PRESS

CAREERS @ HCPRO

ADVERTISING OPPORTUNITIES

ONLINE STORE

200 HOODS LANE

P.O. BOX 1168

MARBLEHEAD, MA 01945, USA

PHONE: 800/650-6787

FAX: 781/639-7857

Copyright Statement	Privacy Policy

*MAGNET™, MAGNET RECOGNITION PROGRAM®, and ANCC MAGNET RECOGNITION® are trademarks of the American Nurses Credentialing Center (ANCC). The products and services of HCPro, Inc. and The Greeley Company are neither sponsored nor endorsed by the ANCC