The delivery of healthcare services is entering a period of significant transition from a price sensitive healthplan-driven service to a patient/provider-driven quality service delivered at a reasonable price.  This change requires that healthcare providers not only focus on healthcare delivery but be better prepared to manage the business aspects of their practices as well.  In todays market, Providers need a partner to help level the playing field.  Health plans ensure that their interests are protected through the language utilized in a proposed contract.  This means that the contract is legally slanted to the disadvantage of the Provider instead of a balanced contract between both parties. In addition to how any future overall operational or contractual issues may be affected, in case of legal action, the Provider would be helpless.  Many plan representatives claim that their plan will not negotiate.  This is true, unless the Provider takes the initiative to carefully review the contract and negotiate.

Properly executed healthcare contracts allow the Provider to perform efficiently and collaboratively.  They should emphasize the strengths and opportunities of both parties.  My goal is to successfully execute a healthcare services contract between the healthplan and provider in an expeditious manner that provides satisfactory long-term value and profitability to both parties. 

One of the most common reasons for not reviewing contracts relates to the excessive rates charged by attorneys.  Although a licensed attorney will not perform these services, the analysis will be nearly identical and based on years of reviewing the results of contracts that were submitted to attorneys.  Furthermore, the fees will be less than half of what is charged by licensed attorneys.

It takes hours and sometimes days to review a contract, and additional time after that to discuss modifications to the language in the agreement.  This usually occurs after there has already been lengthy discussions regarding reimbursement.  As a medical Provider, your time is better spent on meeting the needs of patients.  However, the importance of reviewing and understanding managed care contracts is imperative.  Why not take advantage of the extensive expertise and experience offered here?

Engagements are typically billed on an hourly basis but may be quoted as a flat rate as warranted by the scope of service and agreed upon by both parties.