Ancillary care providers have unique managed care contracting challenges. You want to increase your provider reimbursements through new or existing contracts, but you may have trouble determining what kind of contract is needed, explaining your value proposition to a payer who is already contracting with a competitor, breaking into closed networks, evaluating your fee schedules, troubleshooting claims for timely payment, and marketing your services to more patients. Getting more referrals may be a challenge as well.
Southwest Medical Consultants can be a low-cost highly efficient alternative to having a full-time staff member(s) to perform any or all of these managed care contracting and related services. We have decades of experience in all facets of the industry, and we can help on an as-needed or ongoing basis.
We offer the following services:
- Contract negotiations: We have negotiated thousands of profitable contracts for ancillary providers and medical practices of all sizes, complexities, and specialties. We have a proven process to handle negotiations from start to finish: many see average provider reimbursement increases of 10%-20% and ROI often exceeds 8x-10x.
- Provider reimbursement analysis: We can dig deep into your current fee schedules and reimbursement agreements to identify areas for revenue improvement. We can perform analyses and modeling that used to take an entire actuarial department.
- Provider credentialing: Thanks to our well-established relationships with payers, we can manage the process of credentialing new practitioners. Document management, processing, and follow-up: you can leave it all to us.
- Claims management: We can troubleshoot claims with payers that are not being accurately processed and reimbursed.
- Marketing and business development: With our nationwide network of contacts at third-party payers, hospitals, large self-insured employer groups, GPO's and other entities, we can get you in the door and connected with new prospective patients.
- Referrals: We can put together a marketing campaign to your targeted referral sources including physicians, medical groups, integrated hospital systems and other sources.
We also can train your staff to negotiate and analyze contracts, as well as fulfill other research and healthcare consulting needs.
There’s a reason why we have rave reviews from clients around the country and are the go-to experts. We have a proven track record and more than 20 years of experience and a leadership team with hands-on experience in the healthcare, managed care contracting, marketing and technology fields. But really, our success is based on your success. Quality work, focus, and passion for you is in everything we do.
Contact us now and let’s discuss your managed care contracting needs and how we can assist.