Keeping Up with New Payment Models Cost Plus or Medicare Plus
Providers across the country are experiencing a new “reality” in payment models where patients are presenting “Medicare PLUS” or Cost PLUS” insurance cards, the latest tactic of self-funded, commercial employee benefit plans. Under these plans, the employer is interpreting a Provider’s assignment of benefits acceptance as a contractual agreement to accept a reduced, non-negotiated payment for services determined to be “reasonable”, typically Medicare “plus” as a percentage….
view article pageManaging Managed Care
Contract negotiations are complete; your managed care contracts are in place … now the real work begins. “Managing” your contracts on the back end is as important as what you negotiate on the front end for all payor types, including Medicare Advantage and Managed Medicaid. Understanding the parameters and administrative and financial expectations of negotiated agreements will maximize contract benefits as well as minimize challenges….
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