Access focused “Issue Briefs” on managed care hot topics, including prior authorization, credentialing, overpayments and recoupments, claims processing and payment, contract changes, and contract termination.
Key issues to consider regarding a health insurer’s initial adverse medical necessity decisions and your appeal rights:
Prior to signing a managed care agreement, what issues should a you consider regarding whether third parties will be able to access your discounted rates?
What questions should you consider prior to signing a managed care agreement containing an all products provision?
What issues should a medical practice consider regarding the term, termination and nonrenewal of a managed care agreement?
What payment issues should you consider prior to signing a managed care agreement?
What should a physician look for in a managed care agreement concerning the health insurer’s ability to change key aspects of the agreement while the agreement is in force?
What issues should a physician consider regarding claims filing and payment prior to signing a managed care agreement?
What issues should you consider when reviewing a managed care agreement with respect to a health insurer’s ability to recover alleged overpayments?