Class 9 – AUDITING MANAGED CARE CONTRACTS AND RELATIONSHIPS
More providers are looking closely at the managed care contracts that they have entered into and are evaluating if they want to continue with the relationship upon renewal time. Providers are terminating contracts and relationships with managed care organizations that they do not find fruitful. Providers are becoming more savvy in the questions to ask and the concerns to have as compared to blindly accepting any terms and conditions proposed to them by managed care organizations. Some providers have developed relations with managed care organizations that are helpful to all parties concerned such as the payor of the health care benefits, the patients, the providers and the health care plans.
An area providers might want to look at involves alternative medicine such as coding and billing standards for treatments. As there may be few Current Procedural Terminology codes specific to alternative therapies.
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