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Practice ManagementAt BSA Healthcare, we look for ways to enhance
your revenue base through proper practice management techniques by focusing on the reimbursement
and contractual issues of your medical practice. We specialize in the following:
- Hospital contracting
- Transition to independent fee-for-service billing
- Fee schedule review/creation
- Managed care contract review and negotiation
Hospital Contracting
Prior consideration of all variables that affect a healthy relationship between the hospital
administration and the physician group will create a viable contract that makes sense for both
parties. BSA Healthcare can help you create an initial hospital coverage
contract, or we can advise you in making contractual changes to an existing agreement. We can
then assist you in the presentation of these materials to hospital administrators.
Transition to Independent Fee-for-Service Billing
Frequently administrators ask an ED group to transition from the present percentage-of-charges
or hospital employee arrangement to an independent fee-for-service relationship. BSA Healthcare
can assist groups and hospitals during these types of transitions. Items to be considered include:
- Interpretation of potential billing vendors' feasibility studies to determine group income
- Determination of ramp-up expenses required to reach the collection break-even point
- Determination of necessary monthly subsidy amounts above the collection break-even point
- The best method in which to underwrite the ramp-up and subsidy expenses
Managed care contract review and negotiation
BSA Healthcare can assist in crafting contractual language for MCOs and other insurance
plans. Potentially damaging language in "boilerplate" MCO contracts includes:
- Paragraphs not directed to a specific type of medical specialty
- Language that demands activities such as medical record storage with MCO access that the practitioner can not provide
- Statements or diagnostic lists that create denied claims based on a very stringent definition of "medically necessary"
- Appeals processes that are weighted toward the MCO
- Claims adjudication processes that delay payment
BSA Healthcare can provide the following:
- A review of the contract submitted by an MCO
- Suggested language changes and justifications
- A focused look at fee-schedules with proposals for change
- Direct negotiation of contractual changes, as your agent, with the MCO
- Assistance to your legal staff in reviewing the contract
BSA Healthcare Services
EMERGENCY MEDICINE & PHYSICIAN SPECIALTY SERVICES
| HOSPITAL SERVICES
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