Negotiating reimbursement rates with managed care companies is an important part of healthcare. To obtain and maintain managed care contracts on an ongoing basis that are profitable is a well-proven method to make the most of patient revenue flow. Flatworld Solutions managed care contracting services have over the years been successfully helping organizations in finalizing contracts that are competitive for providers across the globe.
Our team of experts will work with you in determining if your organization is positioned well enough with each payer and determine the steps that will be necessary to improve your relationship with your payer.
Managed Care Contracting Services We Offer
Through our managed care contracting services we provide healthcare providers a way to grow and stabilize their revenue flow and gradually transition to a more value-based care structure. As a Managed Care Contract service provider, we offer the following services -
Managed Care Contracting
A proactive approach to the relationship between payers and providers. Let our team of specialists' experts take the contractual effort out of your liability by renegotiating old contracts and developing new managed care partnerships.
Reimbursement Audit & Recovery
Where billing departments or third parties are not enough, our Flatworld Solutions Audit and Recovery Team can help you get back payments. We work with customers with historical claims and refund data to track payer repayment patterns, identify defects, and track unpaid amounts on your behalf. If you are outside the network, Flatworld solutions will help you to hold accountable those who have paid fees.
Foundation & Scholarship Support
While customers are looking for more alumni and community engagement, Flatworld Solutions has a long history of managing services by incorporating industry best practices into organizational management efforts. We have a Scholarship Program that brings us time - proven fundraising strategy - to life, helping providers expand access to care by validating quality.
Substance Abuse Treatment & Behavioural Health
Inpatients and outpatient treatment facilities can use the full range of services offered by us. Our negotiation process helps organizations stand out in a highly competitive industry by enabling us to work with insurance companies to achieve optimal rates and expand access to critical services.
Referrals and payers are demanding more of post-acute care providers than ever before. We know what our customers expect of us and hence develop new skills and take the quality of our services to the next level.
We interact with payers across the world every day. Flatworld Solutions can help your portfolio company translate size and scalability into profitability.
Facility and Provider Credentialing
Our provider registration solution proactively tracks and prevents missteps that can delay repayment. Our specialists and identified facilities will help you ensure that your application is processed correctly with the MCO and state authorities the first time. Stop struggling with papers and do not miss an opportunity to negotiate again.
Our team at Flatworld Solutions helps our clients find solutions to finance treatment on behalf of their patients. This usually consists of an outsourced benefit assessment and can include a patient seeking help to pay for costly treatments.
The shift to value-based care offers providers the chance to stand out from the crowd. Advanced thinking payers and providers work with Flatworld Solutions to identify and track the results that are important to the payer. Our customers can help determine what is worth to their field of expertise.
Our Managed Care Solutions
Flatworld Solutions managed care solutions work to help secure contracts that are competitive and create a strong relationship with the payer. Our managed care solutions include -
Obtaining, managing, and maintaining contracts. Review and Assess, Strategy Development, Advice, Negotiate, and ongoing monitoring.
Physician and Clinicians credentialing, workers' compensation credentialing, commercial insurance credentialing, government payer credentialing, Medicaid applications, Medical License Application Processing & Tracking NPI Registration (Type I & Type II), Individual Medicare Enrolment Evaluation, Collection of All Documents/ Information, From Providers, Necessary to Complete Payor Applications, Management of the Credentialing Database Established for Each Client.
Value-based payment models and reimbursements, Evaluate the current Managed Care Contract Position, Identify the Population Health Improvement Opportunity, Determine the Value-Based Models appropriate, Collaborate with the managed care plan to Define Capabilities & Tolerance, Select the Quality and Performance Measures, Construct the Framework that aligns with the managed care plan, Execute the Agreement with enhanced reimbursement, Review healthcare provider performance and Recalibrate.
Optimize all revenue flows for long term stability, and revenue cycle optimization to evaluate and identify areas of opportunity.
Maintaining and developing a strong provider network, expanding an existing network, maintenance of the existing network.
Flatworld Solutions' Managed Care Contracting Team
Flatworld Solutions managed care contracting team will -
Contact clients with exclusive payer contacts and present specialized business propositions.
We will manage all client credentials and demographic information that is required for new and ongoing contracts.
During the contract negotiations process we will finalize and complete all applications.
Provide Rate & Language Review
Assess the contract rates and language for negotiations and revisions.
Negotiate managed care contracting plans and rates.
Facilitate the execution and distribution of contracts.
Assist with Contract Installation
Educate the staff of the client and payer for successful contract installation.
Advise the clients on the protocols of working with payers effectively and developing alternate payment methods.
Address any contract-related issues and queries including dispute resolution, claims, and authorization.
Update on Compliance
Update clients on information on products and processes of payers that are critical to compliance.
As a managed care contracting services providing company, we will provide continuous and ongoing monitoring of contracts for adjustments of terms and conditions, changes in rates, and renewals.
Managed Care Contracting Process We Follow
Our Managed care contract service process is simple and with fewer delays and fewer costs. It oversees all aspects of managed care contracts and is transparent to clients. Some of the key steps in our process include -
01. Discovery Phase
Before we start our process of managed care contracting services, we conduct a thorough research about each facility and gather all data from the government and insurer as well as perform market research and compare facilities, specialists, locations, facility services, and the most recent market activity
02. Project Initiation
Once we take up your project, we begin with a contract and/or credentialing. We then log in all activities and give the client a report of the progress regularly so the client can check the progress. We send a similar progress log report to the staff at the facility, so they are always aware of the reimbursements and admissions
03. Ongoing Recertifications
We log all expirations and set up alerts to ensure once the facility is set up, there are no lapse on any rectifications and/or submissions. This is done for the facility to run smoothly with a valid license, certification, and for the facility to be in contract with each party
04. Approval Process
Before sending the contract to the client for the consent and final signature, each contract is reviewed and thoroughly checked against a pre-approved checklist to ensure there are no exclusions. Once the contract is reviewed and approved by our specialists, it is then sent to the client for approval
Other Healthcare Support Services You May Benefit From
Why Choose Flatworld Solutions for Managed Care Contracting Services?
With Flatworld Solutions, you can rest assured that your managed care contracting needs are in the best hands. Our specialists work with your team to achieve and exceed goals that are set.
With our competitive flat monthly professional fees, you will be saving money by outsourcing your managed care contracting services to us instead of employing individuals with reasonable experience.
We have achieved HIPAA compliance and ISO 27001 certification and hence guarantee to safeguard your facility data. We have in place stringent data security protocols to uphold any information that can affect business.
ISO Certified Service Provider
With our ISO 9001:2015 certification, Flatworld Solutions has showcased its commitment towards delivering high-quality, innovative, and value-based managed care contracting services to healthcare providers.
Our team of experts will manage all office and finances, billing-related tasks, and credentialing effectively and efficiently, leaving you with time to take care of the facility and patients.
Access to Highly Skilled Professionals
All our staff have a thorough knowledge of managed care contracting solutions and are all experts in reimbursement and contract terms. Our team is in constant contact with every facility, monitoring all managed care contracting solutions as per protocols.
Our departments work together with your team at your facility to help generate the maximum revenue. Our systems and management ensure each facility that we work with meets and exceeds their requirements in terms of revenue.
24/7 Customer Support
Since we provide our services worldwide, we have a customer service support team that is available 24/7 to answer your queries and assist you in making sure there are no delays and more rapid turnaround times.
Dedicated Account Manager
We provide each facility with a dedicated and designated account manager who along with their team directly oversees all the workings of managed care and provide solutions.
To maximize your revenue, we customize our software as per your facility requirement to accurately monitor coverage, reimbursements, generate an analysis of procedures, identify challenges, and accordingly provide assistance.
As your managed care contracting service provider, we will provide you with the support to prepare monthly reports that will assist in managing the revenue cycle and boost profitability.
We have the best talent and resources to customize your managed care contracting services. We are equipped to scale up as per your facility and healthcare needs. Our quick scalability will reduce the load on your staff assisting them to focus on core responsibilities.
Customer Success Stories
DME Billing Services for a California-based Client
A top client headquartered in California needed a reliable DME billing service provide and chose us because our experience and proven capability. The outsourced billing tasks were completed in time with 98% accuracy.
Full-Services Billing Services Using Medisoft
A client headquartered in Florida needed a service provider to help them with full-service medical billing with Medisoft tool. Our team empowered the client with cost-effective services in no time.
After several days of monitoring the encounters, I believe your team has done a great job and we are ready to hand over the task of approving the encounters. I truly appreciate how smooth this process has been. Keep up the great work!Spokesperson, Healthcare Service Provider, USA More Testimonials »
Outsource Managed Care Contracting Services to Flatworld Solutions
Flatworld Solutions is a one-stop-shop for all hospitals that are trying to optimize reimbursements of payers, whether to revise the rates, add value-based care, or investing in managed care relationships. Outsource managed care contracting services to Flatworld Solutions and a plethora of other healthcare BPO services and allow your organization to be in constant touch with payers across the world and create staff efficiencies. We provide healthcare providers services to grow and stabilize their revenue flow gradually and effectively and help them transition to more value-based care.
Contact Us right away to outsource managed care contracting services to get quality services.
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