Do you want to know what healthcare contract management is? Let’s read this article & learn about the healthcare contract and policy management processes.

1. What is Healthcare Contract Management
in Medical Billing?
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2. US healthcare facilities and companies sign up contracts with a wide range of
insurance companies every year. All payers have different policies, standards,
parameters and regulations to follow. Therefore, keeping track of all contracts
is an enormous task, especially when the US healthcare industry is observing
so many new reforms like the ICD-10 Code Set Implementation.
To streamline the contract and policy management processes, Providers
should consider outsourcing to medical billing companies. This way, they will
get paid as per their managed care agreements. Let’s delve deep into the topic.
Introduction
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3. Patients have different insurance policies and to tend to them, Providers and
healthcare facilities tie-up with many insurance companies.
 They sign healthcare contracts that are legal documents containing medical
service repayment details. In this fast-paced, competitive industry, time is
money! So, most Providers focus on patient care and overlook the vital clauses
affecting the contracts or negotiate a good rate.
There are also other elements like what benefits are covered, stop-loss
provisions, incentives, service & accessibility issues and provisions for
counting/allocating members.
All of these factors have to be properly analyzed and managed. If not,
Providers will experience delayed and improper payments.
What is Healthcare Contract Management?
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4. Providers and healthcare organizations signing up contracts with Payers is
not a one-time event. It happens every year! So, they have to re-credential with
each Payor annually.
The contract rates of each insurance company are revised and updated,
yearly.
It’s not an easy task to review each Payor’s updated policies and contract
rates every year. To do that, Providers will need the help of medical billing
companies.
Recurring Event
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5. An outsourcing company identifies the top 5 payors of a Provider/healthcare
facility and check if they pay as per the contract.
It creates and maintains a database to manage healthcare contracts. The
database shows the policies and fee schedules of different Payors.
 For easy accessibility, the Payors are differentiated into Government,
managed care and commercial.
What does an Experienced Medical Billing
Company Do?
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6. Using this database, a medical billing company can easily track
payments. Also, it can identify which Payor didn’t pay and analyze the next
steps to get the owed payments.
The company does a thorough analysis of the Payor’s contracts and keep an
eye on what is changed and what remains.
It outlines procedural details and risk mitigations while enunciating key
clauses and offering unlimited templates during the re-credentialing of
the healthcare contract management process.
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7. If you are looking for a reputed and skilled healthcare contract
management company, then MGSI is your best bet. Whether it is
credentialing or re-credentialing, this Florida-based medical billing
company takes care of everything as it has more than 20 years of
experience in the domain.
One of the best medical billing companies in the US, MGSI will
negotiate the right agreement that will create a long-term Payor-provider
relationship. To learn more details, log on to www.mgsionline.com.
About US
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8. You can find us at:
info@mgsionline.com
or
call us: 1-877-896-6474
Any questions?
Thanks!
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