Finally, it is important to know which third-payer you are contracting with. What do you know about its financial stability? Will it be able to settle its debts in a timely manner? How is the public perceived, both from the point of view of consumers and other suppliers? Is there an ongoing procedure on this? What is his track record in terms of customer satisfaction? n. a person who is not a party to a contract or transaction but is involved (for example. B a buyer of one of the parties who participated in the signing of the agreement or who made a rejected offer). As a general rule, the third party has no legal right to do so, unless the contract has been entered into in favour of the third party. Ultimately, third-party payers want to ensure that they can keep their costs low compared to the top premiums or bonuses they receive to support their participants. Our country`s health care system requires most health care providers to enter into contracts with insurers and management care organizations. „Managed Care“ and „Managed Healthcare“ are used to describe methods to reduce health costs and improve the quality of patient care. A care delivery management system (theoretically) reduces costs and improves the quality of care through certain techniques, including financial incentives for physicians and patients to choose less expensive treatments, involve plan beneficiaries in costs, increase outpatient surgery and reduce hospital stays, and closely monitor the situation of costly patients. There are different types of management care organizations with different elements of their business models. Unfortunately, managed care has led to considerable complications and problems in our health care system, making health care happy and cost-effective for doctors and many other health care companies. To negotiate favourable terms, companies need to understand where they have leverage and what types of risk-based payment options they want to follow, if any.
For example, are you the only network in the city? Does a third party need your organization to meet the adequacy of the network? Compared to others, do you have the highest quality or the highest value? Are you willing to offer or consider another repayment model, such as bundled payments. B, shared savings, service charges or payment terms per member per month? If so, does it have the necessary reserves to keep the potential risk down? With offices in Atlanta and Augusta, our business and health law firm advises and represents health care providers on third-party payers` legal issues. Certain provisions in third-party contracts can have a significant impact on a supplier`s revenues. Our services include: Once you understand the rules and what is important to third-party payers, you will need, as a supplier, to define your promise of value. It is important to articulate your services, quality and results in terms of how you can help third-party payers provide their members with a cost-effective, quality service and meet licensing, quality, performance and other contractual obligations.