Managed Care Contract Review Checklist

October 28, 2005

Use this checklist to review managed care contracts.

To download and view the rest of the checklist, click here: Contract Analysis Checklist.doc


 

MANAGED CARE CONTRACT ANALYSIS CHECKLIST

 

Contract Name: _______________________________________   Date:___________

 

PRECONTRACTING CONSIDERATIONS:                                                        Yes     No       N/A

1. Have you asked, received and reviewed financial statements? ___*    ___     ___

Comments regarding financial statements (attach copy).

_____________________________________________________

_____________________________________________________

_____________________________________________________

2. Have you called the state regulatory agency and:

a. reviewed records there?                                                           ___*    ___     ___

b. verified licensure?                                                                     ___*    ___     ___

c. verified type and amount of insurance the MCO carries?       ___*    ___     ___

d. ascertained that the MCO is accredited and by whom?           ___*    ___     ___

e. ascertained compliance/complaints/lawsuits pending?         ___*    ___     ___

Specify:_______________________________________________

______________________________________________________

______________________________________________________

3. Who owns the managed care organization? ___________________

______________________________________________________

a. Who are the medical directors of the MCO? ______________

___________________________________________________

___________________________________________________

___________________________________________________

b. How long has the MCO been in business? _________________

c. Is the MCO a “for profit” or “not for profit” entity? ____________

___________________________________________________

d. What type of legal entity is the MCO? _____________________

___________________________________________________

e. What are the MCO’s growth projections? __________________

___________________________________________________

___________________________________________________


To download and view the rest of the checklist, click here: Contract Analysis Checklist

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