Chapter 22 includes:
Preparation for Contracting
- Gather Information About the Health Plan, Payment Methods, and Reputation
- Be Familiar With the Various Payment Models
- Establish Center Objectives and Determine Leverage in the Marketplace
Contract Review and Establishing Action Points
- Affiliates
- Arbitration
- Capitation and Carve-Outs
- Clean Claims and Claims Provisions
- Covered Services
- Credentialing, Eligibility and Verification
- Evergreen and Renewal Provisions
- Indemnification and Mutual Liability
- Medically Necessity
- New Plans and Product Lines
- Policies, Procedures and Obligations
- Professional Liability Coverage
- Termination Without Cause
- Unilateral Modifications
- Negotiation
Contract Follow-up
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