Managed Care Contracts include Medicare Advantage Plans, Commercial Plans, Tricare, Workman’s Compensation, and Medicaid Health Plans. Understanding how these fit and operate within your market can be a confusing process. MCCFL has the knowledge and experience to break it down into understandable and actionable steps to help you build these new revenue streams.
Comprehensive Contract Management
Over the past decade, MCCFL has developed strong working relationships with multiple insurance carriers for Medicare Advantage Plans; Commercial Insurance; Workman’s Compensation; Tricare; and Medicaid Health Plans on Local, Regional, and National levels. We network with Ancillary Provider Contracting Officers and Provider Relationship Managers to access a broad array of group contracts as well as individual client contracts. We negotiate contract rates with the flexibility for clients to join an existing MCCFL Network group contract or to facilitate individual contracts as new opportunities within health plan networks develop. We advocate for you to have appropriate reimbursement as contract proposals are negotiated.
Along with contract applications come credentialing requirements. MCCFL team handles the entire process from start to finish. Working with our clients, we assemble and compile all the credentialing (and re-credentialing) documents associated with application submissions. Our experience and working relationships with contracting officers enhances our ability to get your application processed sooner. In addition, we work with the claims processing departments to get your contracts loaded into their systems – and prompt corrective actions when needed to minimize claims processing disruptions.
MCCFL believes its market analysis process will quickly identify and bring your contracting opportunities to forefront. Market penetration rates by Managed Care Health Plans are evaluated by county and within the context of client strengths to offer unique care services that are sought by the Health Plans. We help you identify strategic synergies for contracting in order to increase your market share as part of your overall business development plan.
MCCFL offers and assists its clients with a variety of tools to assist your admissions team with obtaining referrals for your facility. The tools available are customized for your facility and designed to inform referral sources of how to transition patients into your setting while meeting provider admission requirements. Having a “system” to educate and facilitate utilization of your contracts increases your success in a competitive market. MCCFL will work directly with your Admissions and Marketing Team to develop an effective managed care process and promote ideas to convey it to referral sources in your community.