Insurance Services

Phone: Houston - 713-429-1487 & Dallas/Fort Worth - 469-648-0571

Fax: 281-946-5113

Consulting Services	Description of Services Offered
Managed Care Strategy	We offer services to new practices as well as those expanding and/or morphing into a new entity. We specialize in evaluating what services to offer in-house and what services to refer out to maximize practice income at the lowest per unit cost to the practice. These services evaluate payor rules, compensation levels, percentage of practice revenue from any single source and how that single course affects practice operations. Evaluating new service lines and creating opportunities within practices or by creating new entities that combine resources, skills, and knowledge from several different practices in different specialties it is also possible at times to create cost savings opportunities for each practice while allowing the owners to invest in new technologies and facilities that create new income opportunities within the healthcare realm.
Managed Care Contracting	With over a dozen years experience contracting for all kinds of different entities both on the provider and payor side, we are well positioned to help practices establish fair contract terms. We evaluate both contract language, business requirements, and compensation terms of each contract. We work closely with a very experienced healthcare attorney as needed with regards to addressing certain contract language issues. There are times when we believe attorney to attorney conversations between the provider and payor can resolve contract language issues that the network development staff at payors are unable to address on their own. Contact us to discuss your specific needs related to managed care contracting. We can customize a solution for your practice be it getting your practice contracted with payors to expand the practice, to renegotiations of current payor agreements to expand services offered or to enhance compensation. We can work on individual contracts or entire slates of contracts depending upon the practice needs.
Physician Practice Management	Modern physician practice management requires more than basic accounting and scheduling systems. If a practice is going to deal with Managed Care, Medicare, Medicaid, and Private Pay patients (domestic and international) it is important to have various controls in place as well as appropriate systems to deal with the various business requirements set forth by the various payors. It is important for practices dealing with significant amounts of surgical procedures and/or hospital admissions to work closely with the payors to ensure proper pre-certification or notification of admissions to ensure compensation is not cut and patients are not subject to financial penalties. Practices that work with multiple hospitals performing surgery and don't have block time also need proper procedures in place to ensure that procedure time is maximized without jeopardizing member care. Other practices need to be more focused on ensuring appropriate access for members who need immediate care while at the same time ensuring members can get follow up visits scheduled at appropriate intervals. Generally there are so many facets of a practice that need to be fine tuned according to specialty and payor mix. We work with the key leadership and owners of the practice to help fine tune the practice. These services are part of an ongoing relationship to ensure the practice is able to operate at peak performance allowing for optimal servicing of patients and optimal compensation. Contact us to discuss how we can work together to improve practice performance.

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