Correct and accurate managed care review of your private practice or hospital can be overwhelmingly complex. Well guess what? It is probably going to get more so in the next year or two. With the impending health care reform act to start impacting health care insurance choices, dollars, increased access to Medicaid and Medicare, and provisions that will directly affect physicians, the complexities will most likely increase.
There are many facets to the managed care structure; payment reviews, payment compliance and reconciliation, accounts receivable collections, contract compliance, and workers compensation audits. It can be a full time job, and as such, many private practices and hospitals outsource their managed care needs to a managed care solution provider that specializes in contract management and contract compliance solutions.
The cost benefit of hiring a managed care and contract compliance solution provider is typically a no brainer. Hiring an expert in receivables management can mean thousands of dollars of revenue recovery that goes directly back into your practice or hospital. Additionally, having an expert on board who can ensure you are in contract compliance could potentially save you even more in fees, penalties, and fines.