HMOs, PPOs, and IPAs are just some of the managed care options that exist today. The commitment of time necessary to negotiate successfully with these entities is often overwhelming for the health care provider. MedTech Billing Service, Inc. has the staff and the experience to assist you in these negotiations, assure you the most beneficial results from your managed care contracts, and allow you to devote your valuable time to your patients.

Listed are some of the services routinely provided by MedTech in Managed Care Consulting:

• Establishing the actual ownership of the managed care organization and determining that the entity is financially sound;
• Negotiating the type of reimbursement – per diem, fee schedule, capitation, etc. – offered;  Assuring that there are no “withholds” beyond the discount agreed upon;
• Determining patient responsibility for non-covered services, as well as co-pays and deductibles;
• Tracking managed care payments to verify the correctness of the reimbursement rate;  Evaluating the appeals process in case of disputes concerning payment issues, utilization review, and medical necessity; and
• Confirming the length of the contract, the renewal process, and the termination options.

Our considerable experience in representing our clients in this arena has prepared us to assure you the most beneficial relationship possible with those managed care entities with which you choose to contract.