Healthcare Contract Management
Insurance & Health PlansMany healthcare organizations fail in healthcare contract management once the healthcare contract is executed and implemented. The absence of an ongoing review leads to overpaid claims and requires additional staff to collect from the provider.
Review all contracts to identify gaps and incorrect reimbursement
An outside independent review of your provider’s contracts can help identify terms and contract rates that need to be adjusted. Just like in medical care, it is always a good idea to get a second opinion. Review of these contracts before renewal can give your organization a negotiation advantage.
Examination of contract models to ensure the expected payment is correct
Review of contract computer programming to ensure accuracy is vital for an efficient operating capacity. Incorrect payments create unnecessary use of your staff resources and negative communication to the healthcare provider. Identification and permanent correction of processing errors will reduce staff re-work expense and create a positive relationship with the healthcare provider.
From Becker’s Health IT & CIO Report about healthcare contract management:
By analyzing data provided by payers, identifying comparable populations within the network to benchmark against, and using the right metrics to gauge performance, providers can thrive under value-based models—using data to recommend changing contract terms on an annual basis.
Complimentary Process Review
Let us review your "new-normal" policies and procedures and evaluate the long-term sustainability of quick pandemic fixes.
Our Complimentary Process Review Includes:
- overview report on your current process
- workflow chart
- recommendations for improvement that you can implement yourself
Ensuring Our Clients Rapidly Achieve Their Financial and Operational Goals in Healthcare Contract Management
Our focus is to help your business grow and run smoothly. We understand the challenges faced with the claims processing and recovery environment. Sunlit Cove Healthcare Consultants provide professional subjects matter experts in the healthcare industry to enhance your business. Our consulting services are available to assist with your day-to-day operations and provide expertise in healthcare contract management.
Revenue Cycle Management Services
Our focus is to help your business grow and run smoothly. We understand the challenges faced within the claims processing and recovery environments. We understand the need to expand telehealth services in our current situation. Telehealth is working, but only if integrated with the right infrastructure and processes.
Experts
Our team of experts at Sunlit Cove Healthcare Consulting have a diverse skillset which allows us to focus on the unique challenges facing the healthcare industry and private or nonprofit physicians’ practices today. Our combined years of expertise in healthcare administration enables us to effectively analyze constraints, problem areas, and challenges.
Leadership | CEO
Lori Intravichit is the CEO of Sunlit Cove Healthcare Consultants. She has more than 25 years of healthcare experience. Lori has extensive experience in healthcare administration in senior management roles within both provider and payer organizations.