MCCFL will assign a Managed Care Liaison to your facility based on geographic location. Your Liaison has real world SNF experience and understands the struggles and challenges a facility faces when dealing with multiple insurance plans. Your Liaison is available to assist with staff training on managed care processes; to handle difficulties that might arise in obtaining authorizations or appropriate level of care determinations; and to advocate when case management or claims processing issues arise.
Staff Orientation and Education
The managed care world is quite complex, confusing, and ever changing. When you join the MCCFL Network, your Managed Care Liaison will come onsite to educate your team in individual, group, or regional settings. We will spend as much time as needed to ensure your ability to navigate the system and enjoy success with your contracts. Providing education to new team members on managed care is a key focus of the support services for clients.
MCCFL will work with your operational team to develop and utilize “best practices” for the day-to-day implementation of your internal managed care systems. Medicare Advantage Plans often require different strategies and processes to handle the delivery of health care than Traditional Medicare. It is important to have internal systems in place to optimize your utilization and reimbursement under the terms of your contracts. Since these terms can vary greatly among the Health Plans, we share our working knowledge of each one with your team and help to customize systems specific to your contracts.
Health Plan Audit Support
Most Health Plans now routinely audit quality of care and services provided as well as the documentation recorded to support billing for the care and services. When audits are conducted, MCCFL is there to assist your team with guidance from beginning to end; providing advice, reviewing findings, and assisting with appeals when appropriate.