Medical providers are constantly seeking to support their organization’s strategic goals, especially by increasing their revenue. However, with patient’s needs legitimately their top priority and consuming the vast majority of their time and effort, healthcare providers often don’t have time to worry about finances or the internal operations of their business. These are jobs for managed care consultants. If you are a healthcare provider, a managed care consultant can ensure your best interests are met by planning, negotiating, and analyzing your managed care contracts.  

What is a managed care consultant?

A managed care consultant works in Managed Care Contracting, also known as Healthcare Contracting. They provide a variety of services including, but not limited to: payer contracting, contract’s analysis, credentialing, claims management, and marketing. Managed care consultants take on these roles, so that healthcare providers may focus in other aspects of their clients, and running a business.

What do they do?

Managed care consultants take the worry out of healthcare operations. They complete services such as superior analytics, hospital managed care contract negotiations, healthcare consulting, even education and training. Hospitals can ensure that their businesses will flourish when working with managed care consultants that show measurable revenue improvement, operational improvement, and productive relationships with payers.

Review and negotiate contracts

One of the most important services that managed care consultants can provide for you is reviewing and negotiating your contracts. Payer policies will often serve their own benefits to maximize profits. This leaves you and your patients taken full advantage of. Managed care consultants will assess your actual claims, executed contracts, and remittances from each payer. Using this information they will know the language and methodology needed to negotiate your contracts. In the end you’ll be making the hospital revenue you expect.  

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