What We Do

Our Services Are Principally In These Areas: 

 

  • Conduct Credentialing and assist in qualifying practitioners for participation in payer networks. 

Experts at Managing Managed Care and Building Market Share

Managed Care Partners has been helping providers manage managed care since 1994. Today we are the outsourced Managed Care Department for over thirty health care organizations.

Our specialty is small to mid-size hospitals and health systems who do not have the need or desire to staff a Managed Care Department but who still have to cope with the complexities of managed care contracts and payer relationships. Utilizing our 25 years of experience and knowledge of the health care industry, we continue to explore new ways to help providers improve contract language and reimbursement.

As a hospital’s Managed Care Department, we:

  1. Review your current managed care agreements in detail and analyze payer trends, allowing you to
    easily compare agreements and fully understand potential pitfalls and opportunities.
  2. Sort out which payers to do business with and which to ignore. Payer solicitations that offer referenced- based pricing options, or reimbursement based on your Medicare cost reports, for example, can be dangerous to your reimbursement health and require special handling.
  3. Set clear goals for negotiation with payers and understand market impacts of your choices. We perform extensive modeling tailored to your facility to evaluate reimbursement and risk sharing arrangements.
  4. Come to the negotiation table equipped with data. Our modeling helps take the guesswork out of evaluating payer offers and counteroffers; our knowledge of payers helps you respond with reimbursement methodologies most likely to be accepted.
  5. Benchmark payer-proposed and existing physician fee schedules for practice-specific comparisons. Our Physician Fee Analyzer reduces the time it takes to evaluate a fee schedule to a matter of minutes.
  6. Audit payer compliance with contract payment terms. We have uncovered hundreds of thousands of dollars in underpayments.
  7. Resolve persistent late or inaccurate payments. When there is a pattern of mispayments, or mispayments are suspected but not proven, we can help compile the information your staff may be too busy to get to and take it up with the payer.
  8. Assist in establishing direct contracts with employers, reducing their health care costs. When a provider can contract with the employer without a payer’s intercession, the relationship is always more favorable for the provider than in a third-party payer arrangement.
  9. Keep the medical staff, the hospital’s Board and management, and the community up-to-date on what’s going on in managed care. We have made presentations to Boards, Finance Committees, Senior Groups and even did a radio program about Medicare Advantage with one of our hospitals.

We welcome the opportunity to tell you more about Managed Care Partners and answer your questions about our services. We can be your outsourced Managed Care Department for a very cost-effective flat monthly fee.  If you are interested in knowing more, please contact Keith Leitzen, President of Managed Care Partners at 630-936-4211.

 

Managed Care Partners, Inc.

875 N. Addison Avenue

Suite 200

Elmhurst, IL 60126

630.936.4211 - phone

630.617.4222 - fax

Additional locations:

Beaufort, SC

Galesburg, IL