Effectively negotiating or renegotiating managed care contracts is a complicated and time consuming effort. Not knowing where your hospital stands in relation to the surrounding market makes the task even more difficult. Provisions that stand in the way of your hospital's ability to obtain adequate reimbursement and unduly restrict billing and appeal timeframes generally exposes the hospital to dramatic revenue losses.
Many hospitals do not have the necessary time, tools and human resources to deal effectively with this important issue. How do you overcome these issues?
Revenue Cycle Solutions, LLC (RCS) is exposed to a wide variety of contractual situations. While still maintaining a very strict client confidentiality policy, we can insure that your hospital is being treated fairly in regard to all areas of compensation. We have negotiated or renegotiated managed care contracts for various sized hospitals as well as health care system members. Our clients enjoy the effectiveness, return on investment and professionalism of our process. Many third-party insurance payers welcome our related experience as an opportunity to facilitate negotiations in constructing a fair and competitive provider agreement.
RCS will prioritize your objectives and establish an action plan on new contracts or segment and analyze the provisions of your existing contracts that are due for renegotiation. Advising on existing or new provisions and consulting with you on the desired outcomes is part of the process.
The process will result in insuring that your hospital is in a competitive position in regard to managed care contract provisions and eliminate the possibility of an unbalanced and unequal outcome. The resulting sound managed care contract provisions will put your hospital on an equitable footing, confident that it is in balance with market competition and optimizing reimbursements on related service revenue.