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2007
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!
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December 1, 2007 - Issue 12 -
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Scrutinize new products as Medicare Advantage continues to expand
Battle over physician prescribing moves to courtroom, while other states seek to legislate protection of prescribing data
Examine assignment, termination clauses before signing EHR license agreement that could jeopardize your data
November 1, 2007 - Issue 11 -
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UnitedHealth settlement may increase provider contracting leverage
Use payer report cards to improve managed care contracts
Evaluate EHR license agreements before you buy
UHC Regulatory Settlement Agreement
October 1, 2007 - Issue 10 -
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Track and manage disputed claims to prevent recurrence
Relationships with employers improve contracting leverage
September 1, 2007 - Issue 9 -
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Employers drive movement to performance-based contracting
Use this pay-for-performance readiness template
August 1, 2007 - Issue 8 -
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Use contractual tools to challenge payer collaboration on products
Consider legal remedies for potential antitrust concerns
Use template to improve negotiations, monitor contracts
E tool: Sample language addresses selective contracting
E tool: Model letter
July 1, 2007 - Issue 7 -
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PROMETHEUS payment model aims to top P4P
Simple audits help to manage payer contracts
E tools: Top 10 CPT codes in family practice example
E tools: Measuring variance between contracted and allowed amounts in CPT codes
June 1, 2007 - Issue 6 -
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Colorado legislature passes landmark managed care bill
Outpatient imaging on UnitedHealthcare's radar screen
Hospital outsourcing now part of managed care contracting
May 1, 2007 - Issue 5 -
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Transparency and health information: Who owns your practice data?
Use these eight strategies to create reports about your financial performance
E tool: Sample contract language addresses data disclosure
E tool: Lovely Medical Group
E tool: Practice Revenue 2005
E tool: Metro Area Integrated Clinic, PC
April 1, 2007 - Issue 4 -
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Medical Home concept gains ground
Contracting challenges affect provider-sponsored plans
Exert control over a payer's policies using these tactics
March 1, 2007 - Issue 3 -
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Use utilization data to win an increase in payer rates
Tips to ensure that payers' audits are fair and equitable
Alter current procedures to reduce silent PPO activity
E tool: Sample contract language to address audit requests
E tool: Model letter
February 1, 2007 - Issue 2 -
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Put quality rankings in perspective
Prepare now for patients with limited benefit plans
Tackle incorrect payments with a notice to the payer
E tool: Model language: Contract violations
January 1, 2007 - Issue 1 -
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Don't underestimate the value of a well-defined contract
Improve your record keeping to reduce underpayments