Provider Services

Managed Care: Making Sure Your Contract Is A Winner.

Dramatic changes in the economics of providing health care have created an increased reliance on managed care contractual agreements. Ensuring that you are being paid correctly under these contracts is a major focus of MGSI.

The reimbursement rate is only one piece of the puzzle. Often times there are not only marketing, service and accessibility issues, but there are also other elements such as precisely defining what benefits are covered, stop loss provisions, various incentives and provisions about how members are counted and properly allocated.

Tough But Fair Negotiating.

Competition is fierce for securing the best managed care contracts, yet, despite the current rush to sign as many contracts as possible, physicians would do well to let our staff review and assist where needed in the negotiating process. Our goal is tough, but fair negotiating upfront. This can go a long way toward avoiding problems in the future.

At least one third of the issues within a contract can be improved if you clarify these issues from the onset. Our thorough analysis of the contract ranges from procedure carve-outs to termination clauses. We ensure terminology is present that protects you; e.g., clauses allowing you to drop a disruptive or non- compliant patient.

Working Collaboratively.

Making sure your contract is a winner depends not only on evaluating your position in the market, but also working collaboratively, displaying flexibility and sharing data with the managed care organization. This will lead to an agreement that is win-win and to a long term payer-provider relationship.

Contact Us For More Information.

For more information on this service and how it can benefit your practice call toll free at 1-877-785-8801 or email.