Ron Brank, a group vice president for Symbion in Nashville, Tenn., offers 10 points on using cost data for managed care contract negotiations. 1. Meaningful data is essential. In managed care contract ...

Early managed care prioritized coordinated primary care “gatekeeping,” selective contracting, utilization/quality controls, ...

Amidst the backdrop of large-scale consolidation across the US health care system, consolidation among Medicaid managed care ...

Here are seven best practices from managed care contracting experts to help you get paid fairly by third-party payors. 1. Give yourself ample time to negotiate a contract. To convince a payor that you ...

Coding of physician office visits can be very confusing – and is ever-changing. Every year, regulations and guidelines change, and it is difficult for providers to keep up. Most groups have coding ...

On April 22, the HHS Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule regulating the use of managed care in Medicaid and CHIP. The official Federal Register version ...