Contract Review and Assessment
Consulting Services | Revenue Cycle | Revenue Cycle Solutions | Managed Care Services | Contract Review and AssessmentContracts can be risky.
Your managed care contracts are solid. You’re getting the best reimbursement rates possible. Right?
Here’s how QHR can help
Maximize revenue. Minimize conflict.
Your hospital needs managed care contracts. And the MCOs need to know they can rely on your hospital. We help ensure your contracts protect your organization.
When QHR’s experts conduct a contract review, they focus on the key language and financial payment issues that must be addressed to avoid unforeseen reimbursement issues or operational requirements that the hospital cannot administer.
Our reviewers see the same boilerplate proposals from key national payers on a regular basis; they know what can be modified. They’ll use this knowledge to enhance the net revenue of the agreements and minimize future conflict with payers that may occur with less clear contract language and financial terms.
QHR contract specialists:
- Use a checklist to ensure that all key issues are identified
- Focus on those items that are known to pose future risk for your organization
- Prioritize recommendations, identifying opportunities offering the greatest financial or operational impact
- Provide proposed language and financial modifications that can be used as counter proposals, as well as backup alternatives
- Include payment methodologies that protect and positively impact your net revenue, taking into account your organization’s specific services
- Point out those contract provisions that cannot be administered without undue additional cost or complexity
- Address ongoing managed care issues, such as silent PPO activities and prompt pay expectations, as well as emerging issues, including high deductible policies, discount cards and Medicare Advantage products.
- Maximize your ongoing net revenue by leveraging the payers’ need for contractual stability
Keep business growing.
Managed care contracts can guarantee your hospital of considerable blocks of business. QHR helps you make sure they also ensure your hospital the best reimbursement rates possible.
