Contract Review and Negotiations

The objective in this area depends on the practice's leverage position in the market. If you have a new practice in an area with many physicians, leverage is minimal and attracting contracts is a means to creating patient volume. Pricing although important is secondary to receiving the contract. The strategy is often to insure that 60-90 day contract outs are available. Once a practice is established, the practice becomes more selective. Contracts are reviewed to protect the practice from such things as solicitation clauses, gag clauses, reassignment of patients following termination, billing and payment cycles as well as compensation. We are also a top source for Healthcare Data Collection in Michigan.

Fee Schedule Matrix

The development of a fee schedule matrix allows a practice to determine how much it makes from each payor by procedure. It attempts to create an apples to apples comparison. This allows a practice to create a scheduling scheme that enhances revenue but also informs the practice about which contracts to continue with if accessibility is limited. The physician ultimately needs to determine at what price he/she is willing to render services. This type of analysis allows the physicians to make an informed decision.

Managed Care Strategy

The development of a managed care strategy is obviously based on many market variables as well as the current status of the practice. A practice must determine what leverage it has in the market and where it wants to grow. A new practice trying to create volume should not be too selective while the practice with little accessibility should be only looking for contracts that will enhance revenues or provide market protection.