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single case agreements

How much do single case agreements cost?

Based upon the business rules and complexity, cost models can be flexed to meet client requirements and may involve one or more of the following methodologies:

  • Per Agreement
  • Percentage of Savings
  • Time and Materials

What are single case agreements?

Provider Single Case Agreements commonly referred to as an SCA are one time agreements between a health plan/payor/third party administrator and a healthcare provider. Southwest Medical offers call center staffing on a full-time or project basis for network development and SCA negotiating. SCA’s are typically negotiated at the time of care, often due to out of network access or other situations that prohibit the care in network.

How do single case agreements work?

Southwest Medical Consultants contract with payors to either provide real-time or retrospective SCA negotiations with Business Rules established by the payor. Southwest Medical is notified by the Client electronically or telephonically then an SCA order is generated, and the negotiation process begins with the provider. Upon completion, all materials are scanned and returned electronically to the payor for processing. Southwest Medical Consulting maintains back up documentation on all negotiated SCA.