If you’re a health care provider, it’s likely that you have been asked to sign a contract for your managed care patients. As it can be a complicated and complex process, it’s important to know what to look for in order to feel as prepared as possible.
Here are some key things you should do:
- Review the Length of the Contract
- Review the Reimbursement Rate
- Consult with Legal Counsel
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Review the Length of the Contract
Reviewing the length of the contract is important because it determines how much you will pay. The longer the contract, the lower your monthly cost will be. For example, if you choose a two year term, your monthly payment may be less than half what it would be for a six month agreement. However, keep in mind that there is no grace period during this time if you’re unable to afford payments. On top of this risk factor, some insurance companies also charge higher fees when their customers renew short-term policies simply because they know their customers are likely going back into negotiations with them again.
Review the Reimbursement Rate
If your employer offers more than one health plan, it’s important to compare their reimbursement rates carefully before making any decisions about which plan to choose. You should also look at how these rates have changed over time; if they’ve been increasing steadily, this could indicate that your benefits are moving towards coverage that includes fewer out-of-pocket expenses and higher deductibles.
Consult with Legal Counsel
Consulting with legal counsel will help clarify anything you don’t fully understand or may be confused by. They can also further clarify the fine print and any points you don’t agree with and would like changed. It’s also important that you ask your agent about the types of claims that are covered by the policy along with the exclusions (reasons why some claims may not be covered), and limitations (the maximum amount an insurance company would pay).
At PayrAdvisors, we offer Physician Practice Consulting and Revenue Cycle Consulting services.
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At PayrAdvisors, our team of experts in the business of healthcare enable us to better solve complex problems and consistently give our client organizations confidence in our execution. Our array of services includes contract negotiation, finance & strategy, management consulting, and more.