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Outpatient Surgery E-Weekly

Malpractice Verdicts Often Favor Physicians

Physicians come out on the winning end of 80% of malpractice claims that end in jury verdicts, according to researchers at Massachusetts General Hos...

Study: CT Colongraphy Effective in Finding Polyps

A CT-scan-based, laxative-free "virtual colonoscopy" may be as effective as standard colonoscopy in finding potentially cancerous polyps, according ...

Wrong-Site Prevention Video Shows the Right Way

Wrong-site, wrong-patient and wrong-procedure surgery must be prevented at all costs. The 3 steps of the Joint Commission's Universal Protocol make ...

Archive > May, 2005 Vol. VI, No. 5

Successfully Negotiating Managed Care Contracts

We asked the experts to reveal their top bargaining strategies.

Dan O'Connor, Editor-in-Chief

When it comes to negotiating a managed care contract, knowledge is power. The more you know about your top procedures and case costs, your desired and minimum margins, and your payers' policies and ploys, the better job you'll do at hammering out a contract you won't be smacking your forehead over in six months.

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Categories: Code/Bill/Reimburse, Business Management
Keywords:
1 Know where your bread is buttered.; 2 Know what sets you apart.; 3 Develop a fair advantage.; 4 Fight nice.; 5 Make contracts easy to administer.; 6 Watch out for the shell game.; 7 Make concessions.; 8 Sweat the details.; 9 know when to walk away.; ASCOA's; ASCs; Alona Zaitzeff, ASCOA's; Ann Deters, CEO; Areas; Billing; CEO; CMS; CPT; Carve; Center Billing; Consulting; Deters, CEO; Develop; Fight; Gray. Areas; Health Consulting; Highlight; Kehayes. Carve; Make; Medford, N.J.-based; Medicare's; Medicare-based; Millennium Health Consulting; Ms. Gray. Areas; Ms. Kehayes. Carve; N.J.-based; Pro... show all keywords
1 Know where your bread is buttered.; 2 Know what sets you apart.; 3 Develop a fair advantage.; 4 Fight nice.; 5 Make contracts easy to administer.; 6 Watch out for the shell game.; 7 Make concessions.; 8 Sweat the details.; 9 know when to walk away.; ASCOA's; ASCs; Alona Zaitzeff, ASCOA's; Ann Deters, CEO; Areas; Billing; CEO; CMS; CPT; Carve; Center Billing; Consulting; Deters, CEO; Develop; Fight; Gray. Areas; Health Consulting; Highlight; Kehayes. Carve; Make; Medford, N.J.-based; Medicare's; Medicare-based; Millennium Health Consulting; Ms. Gray. Areas; Ms. Kehayes. Carve; N.J.-based; Providers; SevenD; Surgery Center Billing; Sweat; Watch; Zaitzeff, ASCOA's; absolute; accept; add; additional; administer.Your; administrative; advantage.You'll; adversarial; affiliate; alerting; apart.It's; approve; areas; assume; average; base; bid; billing; bit; bread; breed; build; business; buttered.Figure; care; carrier; carve; case; cases; cautions; center; charges; chase; clauses; code; coding; company; concessions.Take; contract; contracted; contracts; copy; cost; cover; craft; creating; crosswalks; cubicle; deadlines; defined; demonstrate; dependent; deserve; desired; details.Make; develop; deviate; differentiate; discipline; discounts; diversifying; dollar; easy; effort; end; equipment; establish; establishing; exclude; expensive; extra; fair; fee; field; filing; financials; find; finding; first-time; flat; follow; forehead; game; game.If; good; gouge; group; grouper; grouper-based; grouping; hammering; high; high-volume; higher; hospital; implant; include; information; invite; invoice; job; knowledge; leave; leverage; losing; love; low-paying; low-volume; lowball; lower; make; making; malpractice; managed; manager; managing; margin; materials; maximize; means; minimize; minimum; modify; move; multiple; mutual; negotiate; negotiating; negotiations; nice.By; objective; offering; offers; ortho; overhead; overly; owner; packs; paid; paper; partner; past; pay; payer; payer-defined; payers; payment; pays; percent; percentage; play; point; policies; policy; president; print; procedure; program; prompt; properly; proposed; providers; question; rate; rates; reading; reassign; recouping; regulations; reimbursement; relationships; rep; represent; represented; requests; require; reserve; responsible; revenues; senior; separate; service; sets; shell; single; smacking; smell; source; split; state; supervisor; supplies; surgery; system; talk; terms; test; time; timely; tip; top; track; trip; true; understand; unfavorable; unique; values; vice; viewing; volume; walk; walkway; working; worth; writing

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