Faculty Emeritus Eastern Kentucky University Richmond, Kentucky
Disclosure: Nothing to disclose.
This session will provide oral and maxillofacial surgeons with an overview of managed care contracts. After participating, OMSs will have a better understanding of the terms typically included in provider contracts, arming them with information they need to prepare for entering into and negotiating provider contracts. Topics covered will include the contract negotiation process; structure of provider contracts; payment-related concerns, such as prompt-payment laws, over/underpayment time periods and various methods of reimbursements; the different types of delivery models; as well as administrative and legal concerns, such as gag clauses, hold harmless clauses and contract termination.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Discuss common managed care models.
Describe the contract negotiation process.
Identify terms that are common in managed care contracts and their impact on the OMS practice.