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How the National Managed Care Contract helps physicians

The National Managed Care Contract (NMCC) database assists physicians and their practice staff in reviewing and negotiating managed care contracts. It is an instrumental tool for holding managed care organizations—both those a practice has contracted with and those it has not—accountable to their agreements and to fair business practices. Physicians also find it useful when establishing practice in another state.

The NMCC makes it easier for physicians to:

  • Negotiate contracts with health insurers
    Use alternative contract language based on existing state laws to negotiate for more favorable contract terms.
  • Ensure that managed care contracts comply with state laws before signing them
    Look up the managed care laws in your state and compare them against managed care contracts to make sure the contracts are in compliance before signing them.
  • Manage ongoing relationships with health insurers
    Look up existing state laws to support your claim appeal letters and file complaints against non-compliant health insurers. Also identify the most physician-favorable laws in the country, your state and surrounding states for guidance on issues that an existing managed care contract may be silent or ambiguous about.
  • Receive clarity on managed care contracting issues
    Access issue briefs that discuss key physician contracting issues—such as medical necessity, contract termination and overpayment recovery efforts—to help you identify and address many of the issues that arise when negotiating contracts and interacting with managed care organizations.
  • Establish practice in another state
    Check out the managed care laws in any state across the country and the surrounding states. You can even compare laws for these states side by side.
  • Review AMA policies
    Find out the AMA policies on specific managed care issues.

Access the NMCC database

 

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