Using a Quick Reference Chart to Track Managed Care Plan Requirements

February 19, 2016

One problem with many medical offices is knowing the ins and outs of every managed care plan the practice is on. This is the type of problem that can and does have a direct impact on the profitability of the office. For example, if a surgeon performs a procedure on a managed care patient without obtaining the appropriate authorizations, the service will usually be denied and the related revenue lost. Another is failing to collect copayments at the time of the office visit because the receptionist does not know how much money to ask for at the time of patient check out.

Practices that have worked with managed care know one key to success is knowing the nuances of every contract. One successful way to track the terms and conditions of managed care plans it to create and update what is commonly called a quick reference chart for managed care contracts. This chart can be used by front desk personnel and well as billing and collection personnel. Simply put, the chart summarizes the most important aspects of each plan. By referring to this chart as needed, the objective is to comply with the requirements of each plan so that revenues will not be lost by the practice. The following is a sample reference chart that can be used by you to help your clients sort out and make sense of their managed care relationships.

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Managed Care Chart

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