Why This Primer?
Managed Care contract review and negotiations are almost always last on everyone’s list, typically because it’s hard to know where to begin to get traction. And that’s half the battle.
This primer SOLVES that problem for you! It’s a self-help, “how to” guide that trains the reader on what to watch for as well as how to advocate for their practice and/or facility.
Frequently Asked Questions
What about all the “legalese” in Managed Care contracts? How does a layperson understand what’s written in them?
Please see the testimonials. I’ve “translated” contract (Provider Agreement) legalese into everyday vernacular that explains what it all means to you in understandable business terms.
How do I know if I’m even prepared to approach third-party payors to seek renegotiation of our contracts?
That’s covered. (See Table of Contents.) The Primer walks you through the process including check lists to determine what you need before and during contract review and negotiations.
Do you provide legal guidance?
No, I am not an attorney. But after more than 40 years in Managed Care I have a solid understanding of the contract review and negotiations processes from both the payor and provider perspectives. (See About the Author.) In the Primer I draw attention to certain potentially problematic contractual provisions that I recommend for review by an attorney or your malpractice carrier.
Do you give real-life examples of roadblocks put up by third-party payors, and how to get around those?
Yes – real-life examples of successes, and also of some roadblocks I could not get around when an inflexible payor’s position was “Take it or leave it.”
What about the payment option that includes an hour of consulting support?
After you’ve read and digested the Primer’s content that hour is yours to use as you wish. Ask questions about the Primer, or about a specific contract you’re considering, or anything else related to contract review and negotiations.
Is additional support available no matter which purchase option is selected?
Yes. My standard rate is $240/hour. Contact me through the Feel Free To Ask link.
Even if using your Primer sometimes we may not be successful in negotiating or renegotiating a certain contract?
You might come up against a particularly obstinate payor that isn’t much bothered if your practice or facility drops from the network and the Members (your patients) are forced to leave the physicians of their choice. Perhaps that payor feels it has plenty of perfectly viable, alternative contracting options – others willing to accept the (dreadful) terms and conditions as-is, and not “making waves.” And some payors have well-deserved reputations for offering marginal or non-viable reimbursements, and preposterous terms and conditions. Sometimes Managed Care is not fair.
But by using the Primer you can be better positioned to determine up-front the viability of proposed reimbursements and which provisions are decidedly unfriendly and potentially problematic. Then how then to push back with suggested alternative language and reimbursement counter-proposals that would move the Managed Care playing field back toward level so that when all is said and done the deal would make dollars and sense.
Buy This Primer!
Note: This Primer is only available as a spiral bound hard copy.
The Primer with Priority Mail shipping included.
Includes Option 1 and one hour of Gil's consulting time (a $240 value!) to answer your questions.
Send a check for $160 USD for Option 1.
Send a check for $260 USD for Option 2.
(either one payable to "Gil Weber, MBA") to:
Gil Weber, MBA
6063 Goleta Circle
Viera, FL 32940
Include the following with your check.
- The practice or facility's name,
- shipping address,
- name of person to receive the Primer,
- a contact e-mail address.
*Priority Mail shipping is $8.95 USD.
Feel Free To Ask.
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