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Provider Contracting and RelationsUpdate for Our QUEST Integration Providers Caring For Hawaii's People Like Family April 2016 (Issue 2)Aloha from Provider Contracting and Relations CCMA Reminders
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How to fill out provider contracting and relations

01
First, gather all the necessary information about the provider you are contracting with, such as their contact details, medical specialties, and network participation requirements.
02
Next, review any applicable state and federal laws or regulations that may impact the contracting process.
03
Create a contract template or use a standard provider contract form provided by your organization.
04
Include important terms and conditions in the contract, such as reimbursement rates, service level agreements, termination clauses, and confidentiality agreements.
05
Clearly outline the responsibilities of both parties in the contract, including expectations regarding quality of care, claims processing, and reporting requirements.
06
Fill out the contract form accurately, ensuring that all required fields are completed.
07
Review the contract for any errors or missing information before submitting it to the provider.
08
Once the contract is filled out and verified, send it to the provider for their review and signature.
09
Upon receiving the signed contract, review it again to ensure all changes and corrections are properly documented.
10
Store a copy of the signed contract in a secure database or file system for future reference and easy retrieval.

Who needs provider contracting and relations?

01
Healthcare organizations or facilities that contract with healthcare providers, such as hospitals, clinics, and managed care organizations.
02
Insurance companies or payers that need to establish contracts with healthcare providers to define payment rates and network participation.
03
Individual healthcare providers, such as physicians, dentists, and allied health professionals, who want to formalize their relationship with healthcare organizations or insurance companies.
04
Healthcare consulting firms that offer contract negotiation and management services to healthcare providers and organizations.

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