The reimbursement rates negotiated with managed care companies in your market are a crucial element to a healthy bottom line. Obtaining and maintaining profitable managed care contracts and managing those contracts on an ongoing basis is the proven method to maximize your patient revenue streams. Since 1996, Strategic Health Care’s Managed Care team has been successful in finalizing competitive contracts for providers throughout the country.
Our team will work with you to determine if your organization is well positioned with each payor and define the steps necessary to improve your payor relationships. You will benefit from working with a team of professionals who have 25+ years of experience contracting with managed care organizations as well as an established reputation of fairness and professionalism throughout the industry. You will benefit from who and what we know.
Clients with targeted, exclusive payor contacts by maximizing unique business leverages and showcasing specialized service capabilities
Client demographics and credentialing information required for initial and ongoing contracting
Finalize paperwork and RFPs as required in the contract negotiation process
Assess proposed or existing payor contract rates and language for beneficial business related revisions and negotiations
With managed care plan to achieve favorable language and rates on behalf of client
Facilitate execution and distribution of mutually agreed upon payor contract
In-service education with client staff and payors to assure successful administration of contract and increase referrals
Advise client on business protocols for working effectively with contracted payors and the development of alternative payment models
Address contract related issues including authorization, claims, and dispute resolution
Update client regarding Information on payor products and processes critical to compliance
Provide ongoing monitoring of the contract rates, terms and conditions for adjustments or renewals as necessary to benefit the client
Credentialing is also a major part of both the contracting division and the network development team. SHC offers a complete menu of credentialing services to all managed care providers including hospitals, SNFs, physicians/clinicians, ASCs, psych hospitals, skilled nursing facilities and all ancillary providers.