Removing Managed Care Red Tape

Beyond Reimbursement: Addressing "Red Tape" Issues in Managed Care Relationships

When assessing your managed care relationships, look not only at reimbursement, but the so-called "red tape" issues as well. Ask your staff this question for each of your payers: "What would you like to have changed with regard to this payer that in turn would make your life easier each day working with that payer."

For example, simplifying paperwork, making authorizations easier to obtain, and removing charge bundling are just a few of these issues. I am sure your staff can think of many more.

When negotiating or renegotiating managed care relationships, medical practices obviously have a tendency to zero in on getting better reimbursement. While this should be the main objective of any negotiation, don't forget to negotiate the "red tape" issues that can help your practice become more efficient and effective when dealing with managed care plans and their enrollees.

While payers don't like to give up more money, they do have a tendency to work with you on the "red tape" issues.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.