The Benefits of a Hospital Contract Review

Today’s health care environment is more expansive than ever. Thanks to advances in technology and treatment methods, the medical field can assist patients in many different ways. However, with expansion comes complexity. Third-party payers, also known as managed care organizations, have taken the place of patients in footing the bill for your services. While you may have an agreeable relationship with your managed care organization, there may be caveats in your contract that are preventing you from optimizing the sustainability of your hospital or clinic. Let’s go over the benefits of a hospital contract review.

Managed care organizations (MCOs) and establishments that render medical services are connected by a managed care contract. It is essentially a business agreement that defines the services that care providers are expected to render, and what the MCO will pay or do to uphold the agreement.

Since MCOs are responsible for much of the terms and conditions that guide these contracts, they tend to benefit the most from them. An unfairly drafted managed care contract has many consequences. For instance, it may put the majority of the costs on your organization, which can result in higher bills for your patients.

Getting a contract review from a managed care consultant can provide key insight into your relationship with your MCOs. These consultants can go over the terms of your contracts, spot oversights or unclear terms, and determine whether your organization is being exploited. Looking over your contract is a smart move that can potentially reduce your operating costs, assert fairer business practices, and reinforce trust in the patient-caregiver relationship. Before renewing your managed care contract, get a second opinion from an experienced consultant.