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1/3/2017Compliance with
Managed Care Contracts:
You Signed It Now You Have to Live With It George S. Bighorn, JD
General Counsel / Director of Compliance
January 31, 2017Learning Objectives
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How to fill out managed care contracts
How to fill out managed care contracts
01
Review the contract thoroughly and understand all the terms and conditions.
02
Gather all the necessary information and documents required for the contract.
03
Identify the specific sections that require your attention, such as reimbursement rates, services covered, and termination clauses.
04
Negotiate the contract terms if needed, ensuring they align with your business goals and objectives.
05
Fill out the contract forms accurately, providing all the requested information.
06
Pay attention to any deadlines or submission requirements mentioned in the contract.
07
Seek legal advice if you are unsure about any aspect of the contract.
08
Keep a copy of the signed contract for your records and ensure all parties involved receive a copy.
09
Regularly monitor and review the terms of the contract to ensure compliance.
10
Maintain open communication with the managed care organization and address any concerns or issues in a timely manner.
Who needs managed care contracts?
01
Healthcare providers and facilities who want to participate in managed care networks.
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Medical professionals seeking to expand their patient base and increase revenue.
03
Organizations aiming to streamline their healthcare services and improve patient outcomes.
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Insurance companies and third-party administrators looking to contract with healthcare providers for network coverage.
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Individuals or businesses interested in receiving cost-effective healthcare services through managed care plans.
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What is managed care contracts?
Managed care contracts are agreements between healthcare providers and managed care organizations to provide services to enrollees under specific terms and conditions.
Who is required to file managed care contracts?
Healthcare providers and managed care organizations are required to file managed care contracts.
How to fill out managed care contracts?
Managed care contracts can be filled out by carefully reviewing the terms and conditions stated in the contract, ensuring all required information is accurate and complete, and signing the contract where necessary.
What is the purpose of managed care contracts?
The purpose of managed care contracts is to establish the terms and conditions under which healthcare providers will provide services to enrollees under a managed care organization.
What information must be reported on managed care contracts?
Managed care contracts must report information such as the services provided, reimbursement rates, quality standards, and responsibilities of both parties.
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