HPS provides managed care contract review and analysis; fee schedule analysis and contract negotiations.

Contract Review and Analysis

The HPS contract summary outlines the key aspects of each managed care contract.  HPS reviews contracts to identify contract terms, including effective dates, termination dates, claim filing and payment guidelines.  HPS also identifies contract terms that would be considered to be a disadvantage to the medical practice.

Fee Schedule Analysis

Managed care contracts typically present reimbursement rates in plan-specific ambiguous language that does not give medical practices a clear understanding of the actual reimbursement rates.  In addition, the plan-specific terminology prevents the medical practice from an actual "apple-to-apple" comparison between its managed care agreements.  The HPS fee schedule analysis identifies the code specific reimbursement rates for each managed care contract and outlines a plan-by-plan comparison.

Managed Care Negotiations

Negotiating managed care agreements requires an extensive knowledge of the managed care contracting process and environment.  HPS guides our clients through the often daunting process by identifying what terms can realistically be negotiated as well as the practical timelines involved.