Securing revenue through improved managed care compliance.
Providers risk losing significant revenue when managed care contractual obligations go unmet. Contracts should identify claim payment expectations and limit administrative responsibilities tied to nonroutine services. Multidepartmental cooperation is needed to ensure compliance before, during, and after service delivery. Providers should employ technology to manage data related to copayment requirements, claims appeals, and patient eligibility.
Lomicka
Edward W
EW
Community Health Systems, Inc., Brentwood, Tennessee, USA. Edward_Lomicka@hotmail.com
D000067:Accounts Payable and Receivable; D003284:Contract Services / Q000191:economics*; D003669:Deductibles and Coinsurance; D005376:Financial Management / Q000379:methods / Q000592:standards*; D019983:Guideline Adherence; D006761:Hospitals; D007182:Income; D007344:Insurance Claim Reporting / Q000592:standards*; D008329:Managed Care Programs / Q000191:economics*; D017008:Negotiating; D016134:Organizational Policy; D010820:Physicians; D014481:United States