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Negotiating reimbursement rates with managed care companies is an important part of healthcare. To obtain and maintain managed care contracts on an ongoing basis that are profitable is a well-proven method to make the most of patient revenue flow. Flatworld Solutions managed care contracting services have over the years been successfully helping organizations in finalizing contracts that are competitive for providers across the globe.

Our team of experts will work with you in determining if your organization is positioned well enough with each payer and determine the steps that will be necessary to improve your relationship with your payer.

Managed Care Contracting Services We Offer

Through our managed care contracting services we provide healthcare providers a way to grow and stabilize their revenue flow and gradually transition to a more value-based care structure. As a Managed Care Contract service provider, we offer the following services -

Managed Care Contracting

Managed Care Contracting

A proactive approach to the relationship between payers and providers. Let our team of specialists' experts take the contractual effort out of your liability by renegotiating old contracts and developing new managed care partnerships.

Reimbursement Audit & Recovery

Reimbursement Audit & Recovery

Where billing departments or third parties are not enough, our Flatworld Solutions Audit and Recovery Team can help you get back payments. We work with customers with historical claims and refund data to track payer repayment patterns, identify defects, and track unpaid amounts on your behalf. If you are outside the network, Flatworld solutions will help you to hold accountable those who have paid fees.

Foundation & Scholarship Support

Foundation & Scholarship Support

While customers are looking for more alumni and community engagement, Flatworld Solutions has a long history of managing services by incorporating industry best practices into organizational management efforts. We have a Scholarship Program that brings us time - proven fundraising strategy - to life, helping providers expand access to care by validating quality.

Substance Abuse Treatment & Behavioural Health

Substance Abuse Treatment & Behavioural Health

Inpatients and outpatient treatment facilities can use the full range of services offered by us. Our negotiation process helps organizations stand out in a highly competitive industry by enabling us to work with insurance companies to achieve optimal rates and expand access to critical services.

Post-Acute Care

Post-Acute Care

Referrals and payers are demanding more of post-acute care providers than ever before. We know what our customers expect of us and hence develop new skills and take the quality of our services to the next level.

Private Equity

Private Equity

We interact with payers across the world every day. Flatworld Solutions can help your portfolio company translate size and scalability into profitability.

Facility and Provider Credentialing

Facility and Provider Credentialing

Our provider registration solution proactively tracks and prevents missteps that can delay repayment. Our specialists and identified facilities will help you ensure that your application is processed correctly with the MCO and state authorities the first time. Stop struggling with papers and do not miss an opportunity to negotiate again.

Patient Advocacy

Patient Advocacy

Our team at Flatworld Solutions helps our clients find solutions to finance treatment on behalf of their patients. This usually consists of an outsourced benefit assessment and can include a patient seeking help to pay for costly treatments.

Outcomes Monitoring

Outcomes Monitoring

The shift to value-based care offers providers the chance to stand out from the crowd. Advanced thinking payers and providers work with Flatworld Solutions to identify and track the results that are important to the payer. Our customers can help determine what is worth to their field of expertise.

Our Managed Care Solutions

Flatworld Solutions managed care solutions work to help secure contracts that are competitive and create a strong relationship with the payer. Our managed care solutions include -

Contracting

Obtaining, managing, and maintaining contracts. Review and Assess, Strategy Development, Advice, Negotiate, and ongoing monitoring.

Credentialing

Physician and Clinicians credentialing, workers' compensation credentialing, commercial insurance credentialing, government payer credentialing, Medicaid applications, Medical License Application Processing & Tracking NPI Registration (Type I & Type II), Individual Medicare Enrolment Evaluation, Collection of All Documents/ Information, From Providers, Necessary to Complete Payor Applications, Management of the Credentialing Database Established for Each Client.

Valued Based

Value-based payment models and reimbursements, Evaluate the current Managed Care Contract Position, Identify the Population Health Improvement Opportunity, Determine the Value-Based Models appropriate, Collaborate with the managed care plan to Define Capabilities & Tolerance, Select the Quality and Performance Measures, Construct the Framework that aligns with the managed care plan, Execute the Agreement with enhanced reimbursement, Review healthcare provider performance and Recalibrate.

Revenue Optimization

Optimize all revenue flows for long term stability, and revenue cycle optimization to evaluate and identify areas of opportunity.

Network Development

Maintaining and developing a strong provider network, expanding an existing network, maintenance of the existing network.

Flatworld Solutions' Managed Care Contracting Team

Flatworld Solutions managed care contracting team will -

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Position

Contact clients with exclusive payer contacts and present specialized business propositions.

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Manage

We will manage all client credentials and demographic information that is required for new and ongoing contracts.

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Complete Applications

During the contract negotiations process we will finalize and complete all applications.

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Provide Rate & Language Review

Assess the contract rates and language for negotiations and revisions.

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Negotiate

Negotiate managed care contracting plans and rates.

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Facilitate

Facilitate the execution and distribution of contracts.

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Assist with Contract Installation

Educate the staff of the client and payer for successful contract installation.

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Advice

Advise the clients on the protocols of working with payers effectively and developing alternate payment methods.

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Address

Address any contract-related issues and queries including dispute resolution, claims, and authorization.

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Update on Compliance

Update clients on information on products and processes of payers that are critical to compliance.

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Provide Monitoring

As a managed care contracting services providing company, we will provide continuous and ongoing monitoring of contracts for adjustments of terms and conditions, changes in rates, and renewals.

Managed Care Contracting Process We Follow

Our Managed care contract service process is simple and with fewer delays and fewer costs. It oversees all aspects of managed care contracts and is transparent to clients. Some of the key steps in our process include -

1

Discovery Phase

Before we start our process of managed care contracting services, we conduct a thorough research about each facility and gather all data from the government and insurer as well as perform market research and compare facilities, specialists, locations, facility services, and the most recent market activity

2

Project Initiation

Once we take up your project, we begin with a contract and/or credentialing. We then log in all activities and give the client a report of the progress regularly so the client can check the progress. We send a similar progress log report to the staff at the facility, so they are always aware of the reimbursements and admissions

3

Ongoing Recertifications

We log all expirations and set up alerts to ensure once the facility is set up, there are no lapse on any rectifications and/or submissions. This is done for the facility to run smoothly with a valid license, certification, and for the facility to be in contract with each party

4

Approval Process

Before sending the contract to the client for the consent and final signature, each contract is reviewed and thoroughly checked against a pre-approved checklist to ensure there are no exclusions. Once the contract is reviewed and approved by our specialists, it is then sent to the client for approval

Why Choose Flatworld Solutions for Managed Care Contracting Services?

With Flatworld Solutions, you can rest assured that your managed care contracting needs are in the best hands. Our specialists work with your team to achieve and exceed goals that are set.

Client Success Stories

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DME Billing Services for a California-based Client

A top client headquartered in California needed a reliable DME billing service provide and chose us because our experience and proven capability. The outsourced billing tasks were completed in time with 98% accuracy.

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Full-Services Billing Services Using Medisoft

A client headquartered in Florida needed a service provider to help them with full-service medical billing with Medisoft tool. Our team empowered the client with cost-effective services in no time.

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Success Stories

Outsource Managed Care Contracting Services to Flatworld Solutions

Flatworld Solutions is a one-stop-shop for all hospitals that are trying to optimize reimbursements of payers, whether to revise the rates, add value-based care, or investing in managed care relationships. Outsource managed care contracting services to Flatworld Solutions and a plethora of other healthcare BPO services and allow your organization to be in constant touch with payers across the world and create staff efficiencies. We provide healthcare providers services to grow and stabilize their revenue flow gradually and effectively and help them transition to more value-based care.

Contact Us right away to outsource managed care contracting services to get quality services.

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Our Customers

Movement Mortgage
Alcon
ARI
Maximus
Redwood E-Learning Systems

AHIMA Healthcare Convention 2016

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Flatworld Solutions

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