Managed Care
Consultation on Contracting,
Negotiation Strategy and Compliance
Over the last 20 years, the founders of
MCRC Group have negotiated hundreds of managed care and other payor
contracts on behalf of hospitals, ancillary
providers, large physician faculty practices and small voluntary
physician groups. On behalf of hospitals, they have implemented
rigorous contract compliance
programs to ensure that highly favorable contract terms were followed
by the health plans. MCRC Group’s founders have managed various
contract arrangements including full risk/capitated contracts, bundled
fees, pay
for performance, DRG, per diem and percent of charges, as well as
negotiated comprehensive enhanced fee structures for small and large
physician
practices, ancillary providers and specialty groups. With exposure to
payor arrangements around the country, MCRC Group maintains a
confidential
data base of best
practice contract terms and can help you assess your market position
and how to improve it.
MCRC Group can:
- Review your current agreements for
strengths and weaknesses, identify gaps in language or multiple/vague
interpretations that might result in a payor’s inability or
unwillingness to comply with YOUR intent of the term
- Recommend specific changes to improve
contract terms, enhancing
revenue and protecting providers from denials and other issues
- Assist in developing a strategy to
successfully negotiate new agreements
and implement a program to ensure contract compliance
