Conducting Payment Reviews at Hospitals and Doctors Offices

Written by admin. Posted in Managed care magazine, Payment compliance, Physician underpayment review

Managed care systems

Hospitals and doctors’ offices that receive payment from insurance companies or government benefit programs need to conduct annual payment reviews. Annual payment reviews are a way for these insurance and government programs to make sure that all hospitals and doctors’ offices that take part in the program follow the strict guidelines set forth by the contracts that were signed.

There are companies that can be hired to handle payment reviews or conduct a managed care review. These companies will send in a series of workers who are trained in assessing a payment system for contract compliance and payment compliance. They will review the system that is in place, look over records, and assess the entire situation.

When the company that is conducting the payment reviews finishes its assessment, it will present its finding to the hospitals, doctors’ offices, and the insurance or government agency. These findings can come back with a good report or with a list of suggestions on how to change the program to make sure it meets contract obligations. Suggestions provided by the company can range from ways to improve revenue recovery to bill collecting.

Find Out More About Revenue Recovery With Managed Care

Written by admin. Posted in Medicaid managed care, Physician underpayment review, Revenue recovery corporation

Medicaid managed care

Managed care review services provide services for doctors and hospitals that cover a wide range of operations. These professionals take care of many of the background services and paperwork that deal with many of the legal aspects of the health care operations. These tasks help to ensure that many components of managed care are running smoothly and effectively through the optimal managed care review system that is in place.

By working with a revenue recovery expert you can get the coverage you need for concerns dealing with Managed Care Contract Review Payment as well as contract compliance audits for all commercial payments. Managed Care Plans, Governmental Payers Silent PPO, Unwarranted Discounting Identification, Recovery Refund Review Credit Balance Reconciliation, Compensation Payment Audits and Accounts Receivable, Revenue Recovery and Collection Denial Management Payment Audits for Medicare and Medicaid Managed Care Plans. They also deal with collecting old, difficult, or complicated accounts receivable.

If you would like to find a professional who can take care of your revenue recovery needs you can search online for skilled professionals who have dealt with these areas and have experience in the revenue recovery field. There are some excellent online resources where revenue recovery professionals post their resume so that those who are looking for a revenue recovery expert can review their resume. This gives employers the opportunity to review and compare resumes and work experience of multiple revenue recovery experts so that they can find the best candidate.

Once you have found some potential candidates for a revenue recovery position you through reviewing resumes you can schedule interviews so that you can meet with the revenue recovery professionals in person. This can be a very helpful way to find out more about the individual and their qualifications as well as their goals in the field of revenue recovery and Managed Care.

Preparing ahead of time for the interview can help you to get the most out of what you have to ask of the potential candidates. Feel free to conduct multiple interviews with the same person if you feel that it is necessary. This can be helpful if your choices are competing neck-and-neck and you are having a tough time making a decision. Keep in mind that if your budget allows it may be helpful to hire a team of revenue recovery experts if it will indeed be necessary for your revenue recovery and Managed Care operation.