Third Party Management Solutions
MBS leverages practice position in the marketplace by evaluating,
negotiating and enforcing third party contracts. Our services
help physicians take control of managed care participation
plans and appropriately align their practice in the marketplace.
Managed Care Contract Evaluation
By reviewing current and prospective contracts and evaluating
the economic benefits brought to the practice, MBS can address
and help rectify unsatisfactory agreements. We examine contract
terms and provisions to evaluate the financial gains brought
to your practice.
Contract Negotiation & Renegotiation
On your behalf, our experts can negotiate and renegotiate
contract terms, such as rates and penalty clauses to secure
participation in advantageous fee-for service or capitation
agreements.
Contract Enforcement
Contract enforcement takes time, diligence and thorough understanding
of all terms in the agreement. Our enforcement services help
reduce infraction occurrences made by the carrier.
Managed Care Reimbursement Audits
Too often, managed care companies breach contract agreements
by purposely denying legitimate claims and reimbursing providers
at a lower rate than rightfully due. MBS will identify those
instances through reporting of reimbursement results by carrier,
and will take corrective measures to ensure appropriate reimbursement.
Capitation & Risk Evaluation
Participation in capitation agreements poses financial risk
to any practice. MBS evaluates the costs and benefits associated
with these arrangements to protect our clients from entering
into unfavorable contracts.
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