Managed Care

Our consultants possess in-depth knowledge and understanding of managed care operations including financial, technological analysis, business development and insurance contracting management. FQHC Germane provides the expertise and tools that medical groups require, ensuring quality and efficient medical delivery with a financially successful outcome.


Services:
 

HEALTH PLAN CONTRACT NEGOTIATIONS

  • Assisting with contract risk analysis, financial modeling and impact analysis
  • Pre-contractual audit preparedness

HEALTH PLAN CONTRACT AUDITING ASSESSMENT

  • Improving revenue performance for contracted insurance risk-based health plans
  • Reconciling eligibility and capitation revenue opportunities by product line

CAPITATION MANAGEMENT

  • Professional capitation analysis
  • Forecasting
  • Financial analysis
  • Risk pool accounting management

NETWORK SPECIALTY & ANCILLARY PROVIDER CONTRACTING

  • Provider network specialty compliance analysis
  • Sub-capitation contracting & management assessment

CLAIMS MANAGEMENT & COST CONTAINMENT CONSULTING

  • Claims administration protocols, audits and analysis
  • Billing audit & recovery
  • Pay for performance planning
  • Encounter data performance analysis

If you're interested in talking to one of our consultants about our managed care consulting services, please fill out the contact form below and we will get back to you within one business day.

Managed Care Services Contact Form

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