Monitoring Health Care Payment Plans

After a health care payment plan contract has been signed and in place for a few months, begin rating the health care payment plan organization (HCPPO) in the following areas:

  • Promptness of payment;
  • Accessibility of provider relations and claims personnel;
  • Competence of staff;
  • Network of providers; and
  • Processes for precertification, referrals, and utilization review.

Think about your experience in each of these areas when considering renewal of the contract. Once you have collected a few months' worth of data on the HCPPO's performance, you will be better prepared to decide whether or not to continue the contract. 

If you need help assessing the value of your health care payment plan contracts to your practice, TMA Practice Consulting can help. TMA consultants can assess many aspects of your practice operations that affect its bottom line, and offer written recommendations for improvement.

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