A Brief Guide to Managed Care Contracting With Synergy Bill Pro
An important but intimidating aspect of running any successful medical practice is negotiating reimbursement rates with managed care companies. Maintaining a few profitable managed care contracts long-term makes it possible to maximize your patient cash flow as other income streams ebb and flow. However, this is challenging for small businesses with limited staff.
Don’t worry; Synergy Bill Pro’s professional managed care contracting services can ensure the negotiation process doesn’t take over the crucial time you should be spending with patients. Outsourcing managed care contracts to our skilled negotiators and administrative team gives you back this time and eases the mental load involved.
What Is a Managed Care Contract?
Managed care contracts are legally binding agreements between healthcare payers and service providers. The contract outlines clear parameters for two elements:
- The compensation the provider receives
- The standard of care the payer expects the provider to deliver.
Managed Care Contract Services We Offer
At Synergy Bill Pro, we offer several managed care service options, including the common ones medical practices rely on us for below:
- New managed care contracting
- Reimbursement audit and recovery
- Foundation and scholarship support
- Substance abuse treatment and behavioral health
- Post-acute care
- Private equity
- Facility and provider credentialing
- Patient advocacy
- Outcomes monitoring
What’s the goal of Synergy Bill Pro’s managed care contracting? We aim to grow and stabilize your practice’s revenue flow while transitioning to more value-based care approaches.
What’s Included in Synergy Bill Pro’s Managed Care Contracting Service?
Choosing Synergy Bill Pro’s services gives you access to our medical billing specialists for all of the following and more:
- Management: Managing logistics and credentials for ongoing contracts
- Negotiations: Negotiating with managed care plans for favorable rates
- Applications: Completing all paperwork required in the contract negotiation process
- Facilitation: Facilitating the execution of mutually agreed-upon payor contracts
- Installation: Educating staff and payors to ensure successful contract administration and increased referrals for your practice
- Advice: Advising you on effective business protocols with contracted payors and issues like developing alternative payment models
- Compliance: Updating you on payor products and processes essential to compliance
- Monitoring: Providing ongoing monitoring for your contract rates, terms and conditions for adjustments, and renewals
With the help of our billing experts, navigating your practice’s managed care contracts is easier than ever. Our comprehensive contracting services mean that our professionals are there with you to perform all the steps necessary for maximizing your profits on the care you’re already providing so well.
Frequently Asked Questions
What Is the Difference Between ACO and MCO?
Typically, the differences between the ACO and MCO options are as follows:
- ACOs focus on care coordination, quality improvement, and shared savings.
- MCOs focus on managing insurance coverage, utilization, and cost containment.
What Is an Example of a Managed Care Organization?
A good example of a managed care organization is a health maintenance organization, such as UnitedHealth Group.
What Is Provider Contracting in Healthcare?
Provider contracting in healthcare refers to the business relationship between the medical service provider and the payor. Parties may include an individual physician, a provider organization, or the multiple care providers you have on staff.
