Contract Negotiation Services

PBS negotiates contracts from the physician's perspective and continuously evaluates and monitors the healthcare environment to ensure that the needs of our members are being met.

Multiple packages are offered depending on the specific needs of your practice. 

 

Baseline Assessment

  • Contract inventory including gathering of contracts, contract and market analysis including an evaluation of the client’s existing market position and leverage.
  • Fee schedule development and analysis.
  • Review of payor mix.
  • Contract language review.

 

 

 Strategy Development

  • Identification of goals, strategy and value proposition (the client’s positioning in the market).
  • Relationship management.
  • Gathering of market intelligence and creative thinking that focuses on each individual client.
  • Strategy plan and recommendations.

Negotiations

  • Selection of negotiation team and method.
  • Initiation and continuation of negotiations including evaluation of proposals and financial modeling.

Contract Implementation

  • Updated contract inventory.
  • Customized fee schedules by payor that are integrated into workflow process and entered into your practice management system.
  • Payment verification.

Denial Management Plan

  • Identify and understand denial reasons including ongoing review of payor coverage and reimbursement policies.
  • Develop a policy to appeal claims.
  • Have regular meetings with payors.

Managed Care Provider Portal Efficiencies

  • Create connectivity to managed care portals.
  • Develop training to ensure utilization of tools to increase online transactions and reduce cost.

 

 

 Contact us today for a no obligation overview of your contracting needs.

 

 

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