Posted: December 8th, 2016

Strategies used to negotiate new managed care contracts.

Billing and reimbursement

Analyze data collection by patient access personnel and its importance to the billing and collection process.

Be sure to address the importance of exceptional customer service.

Analyze howthird-party policieswould be used when developing billing guidelines for patient financial services (PFS) personnel and administration when determining the payer mix for maximum reimbursement.

Organize the key areas of review in order of importance for timeliness and maximization of reimbursement from third-party payers. Explain your rationale for the order.

Describe a way to structure your follow-up staff in terms of effectiveness. How can you ensure that this structure will be effective?

Develop a plan for periodic review of procedures to ensure compliance. Include explicit steps for this plan and the feasibility of enacting this plan within this organization.

IV. Marketing and reimbursement:

Analyze the strategies for negotiating new managed care contracts. Support your analysis with research.

Communicate the important role that each individual within this healthcare organization plays about managed care contracts.

Be sure to include the different individuals within the healthcare organization.

Explain how new managed care contracts impact reimbursement for the healthcare organization.

Support your explanation with concrete evidence or research.

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