Wednesday, March 14, 2012
Leverage legal protections in dealing with health plans
Negotiating a managed care contract? An AMA resource can empower physicians in small and large practices alike to take advantage of their protections under state and federal law during contract negotiations and subsequent interactions with health insurers.
The AMA's National Managed Care Contract Database (available to AMA members only) can help you hold health insurers accountable to fair business practices. If you're negotiating a contract, the database provides alternative contract language based on the most physician-favorable laws. You can also look up your state's managed care laws to confirm that your contracts are in compliance before signing them.
In addition, the database can help you identify and address such key contracting issues as medical necessity, contract termination and overpayment recovery efforts.
If you're dealing with unlawful health insurer practices, the database provides existing state and federal laws that the insurer must abide by. The laws are easy to find through a simple search, and you can easily insert them into a letter to the insurer or a complaint to your state's department of insurance.
Not an AMA member? Join today.
AMA offers resources and strategies for success
The most successful medical practices excel in four key performance management categories, according to a survey released in January by the Medical Group Management Association.
Based on data from nearly 550 high-performing medical practices, the survey findings suggest that these four management behaviors could be the key to success:
- Profitability and cost management
- Productivity, capacity and staffing
- Accounts receivable and collections
- Patient satisfaction
The AMA's Rapid Process Improvement Initiative provides step-by-step guidance to help you examine your practice's performance and make meaningful changes to business operations, practice connectivity, collections and patient satisfaction. The initiative also offers a variety of helpful resources and tools that help you make practice management enhancements with ease.