Managed Care Newsletters

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!

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Managed Care Contracting and Reimbursement Advisor

Issue 12, December 1, 2009 - VIEW THE FULL ISSUE

• Prepare for cooperation, scrutiny, and declining reimbursements in 2010

  MCCRA asked several experts on reimbursement and contracting issues to offer a forecast for 2010.

Issue 11, November 1, 2009 - VIEW THE FULL ISSUE

• Learn how to challenge flawed ratings, tiers

  Payers have various rating, tiering, and ranking systems that attempt to assess a physician’s...

• Silent PPOs, unintended discounts, and your bottom line: Learn how to identify and address leased networks

  “Silent PPOs” can access a provider’s discounted rates without the...

Issue 10, October 1, 2009 - VIEW THE FULL ISSUE

• Articulate when and how payers can access records

  Healthcare organizations should include contract language that will clearly define just who has...

• Insurer report card reflects progress

  The AMA’s second annual National Health Insurer Report Card (www.ama-assn.org/go/reportcard...

Issue 9, September 1, 2009 - VIEW THE FULL ISSUE

• Negotiate better terms, avoid costly pitfalls

  A well-negotiated contract can increase revenue and reduce hassles. 

• Experts offer last-minute RAC advice

  They’re here. RAC automated reviews began earlier this summer, with some complex reviews...

Issue 8, August 1, 2009 - VIEW THE FULL ISSUE

• Renewals: To negotiate better terms, know where you stand

  Carefully considered negotiation can lead to more favorable contracts, yielding higher rates and...

• On average, insurance-related paperwork costs more than $60,000 per year, according to new study

  Physicians spend, on average, 43 minutes each workday dealing with insurance-related issues...

Issue 7, July 1, 2009 - VIEW THE FULL ISSUE

• Prepare for aggressive recovery efforts from self-funded employers

  The success of CMS’ Recovery Audit Contractor (RAC) pilot is not only leading to its...

• Book excerpt: Alignment improves payer relations

  HCPro recently published The New Era of Healthcare: Practical Strategies for Providers and Payers...

Issue 6, June 1, 2009 - VIEW THE FULL ISSUE

• Build your own payer report card to assess performance data

  A new trend with insurers is to pull out a report card that rates your organization’s...

• Use arbitration effectively in payer contract language, dispute resolution

  Providers typically view arbitration as an alternative to litigation in order to settle disputes...

Issue 5, May 1, 2009 - VIEW THE FULL ISSUE

• Take a business approach to your managed care contracting strategy

  Whether negotiated payment arrangements represent a small or large portion of your net patient...

• Do your homework before going out of network

  Two databases of usual, customary, and reasonable (UCR) rates owned by UnitedHealth Group’s...

Issue 4, April 1, 2009 - VIEW THE FULL ISSUE

• Use lessons learned from capitation to improve managed care performance

  Contrary to popular opinion, capitation isn?t such a disagreeable form of contracting?especially...

• Prepare your organization for machine-readable patient ID cards

  The HealthLeaders Media Industry Survey 2009, developed by HealthLeaders Media, a division of...

Issue 3, March 1, 2009 - VIEW THE FULL ISSUE

• Consider collection agency to handle delinquent accounts

  When to send accounts to a collection agency is an increasingly important decision as payers shift...

• Prepare your organization to comply with Red Flags regs

  When Congress passed the Fair and Accurate Credit Transactions Act of 2003 (FACTA), little did...

Issue 2, February 9, 2009 - VIEW THE FULL ISSUE

• Involve physicians in your managed care contract negotiations

  Managed care contract negotiations tend to focus on financial and legal issues, but overlooking the...

• Cash in on Medicare bonus for e-prescribing

  Physicians can earn thousands of dollars in additional Medicare Part B FFS revenue during 2009 if...

Issue 1, January 1, 2009 - VIEW THE FULL ISSUE

Issue 32, September 25, 2009 - VIEW THE FULL ISSUE