■ Process includes the use of a checklist
to insure that all key issues are identified
for potential change along with the provision
of "best contract counterproposals".
■ Process results in the provision of proposed
language and financial modifications that can be
electronically pasted to a hospital counteroffer.
■ Process takes advantage of seeing the same
boilerplate proposals from key national payors
on a regular basis and knowing what areas typically
can be modified for improvement by a key payor.
■ Process often includes initial "counter proposals",
as well as "backup alternatives" if payor is unresponsive
to initial proposal.
■ Recommendations are prioritized to identify
those changes with the greatest impact financially
and otherwise.
■ Recommendations include "payment methodologies"
that protect and positively impact the net revenue
of the hospital, taking into account its specific services. | ■ Recommendations will address those items
that are known to be "reimbursement killers" or
pose "future risk" for the hospital.
■ Recommendations address those contract
provisions that can not be administered without
"undue additional cost or complexity".
■ Recommendations address ongoing managed
care issues such as "silent PPO activities", prompt
pay expectations, as well as emerging issues such
as "high deductible policies", "discount cards", and
Medicare Advantage products.
■ Recommendations maximize ongoing hospital net
revenue by leveraging contractual stability needs of the
network for predictable ongoing increases. |