Description
The five (5) key components to effective contract management are as follows:
- Identify how the managed care environment, players, and dynamics can impact your organization.
- Review insurance, PPO and ERISA plan contracts in order to successfully maximize reimbursements and minimize denials.
- Recognize problematic contract terms affecting both reimbursement and operations.
- Discuss capitation per diem and percentage of charges rate, and understand the risks assumed, plus develop strategies for managing and sharing those risks.
- Review the driving forces in managed care (including healthcare reform), specifics on payer initiatives, public policy, and patient service imperatives that are shaping change.
In a 1-2 page Word document, explain how each one impacts contract management in your own organization (or an organization that you may have encountered in your own research). Then, give an example for each key component of how contract management would be negatively impacted should that component be ignored.
Explanation & Answer
Attached.
Running Head: CONTRACT MANAGEMENT
Contract Management
Student’s name:
Instructor’s Name:
Institution affiliation:
Date:
1
CONTTRACT MANAGEMENT
2
Contract management art of managing a contract in terms of creation, implementation,
and to maximize its performance, while minimizing the costs as much as possible (financial
risks). All organizations need to be careful of contracts they get into and know their strengths
as well as loopholes that can lead to financial risks for them later.
Managed care organizations are third party players negotiate the talks between patients
and healthcare practitioners, (Shaffer, 2001). They can be insurance companies, administrators
or contracted managers. They influence an organization because of their ability to determined
who and how a patient receives treatment from and also what type of medical care can be given
to a patient in a given scenario. Failure to comply with these can lead to lawsuits. Players, in
this case, are patients, healthcare practitioners, investors, and government policies. Everyone
has to play their role efficiently...
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