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Contract Review & Negotiation Overview - GetixHealth
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Contract Review & Negotiation Overview

Everything You Need for Efficient Payer Contracts

GetixHealth understands that payer contract management can be a challenging and resource intensive process. To assist clients, GetixHealth can provide experienced consulting support services through the process that can assist you and provide stronger contract outcomes.

Contract Review

GetixHealth performs detailed contract review to identify potential contract opportunities and risks.

Contract Negotiation

Comprehensive contract negotiation services to expand the efficiency of your practice.

Follow-up & Support

GetixHealth takes the time to monitor necessary follow-up and support for efficient payer contracts.

Contract Review

GetixHealth will take the following steps to assist clients in its review of the payer contract:

  • GetixHealth will undertake an initial review of administrative contract terms.
  • GetixHealth will undertake an initial review of reimbursement terms and methodologies.
  • GetixHealth will evaluate any financial and/or administrative counterproposals from payer.
  • GetixHealth may compare the contracts proposed rates to other client contracts.
  • This process usually takes a maximum of 10 hours but may be increased dependent on the complexity, length, exhibits, and products included in the contract.

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Contract Negotiation

GetixHealth will take the following steps to assist client in its negotiation of a payer contract:

  • GetixHealth shall maintain current and ongoing contract with payer on behalf of client until client has determined negotiations.
  • GetixHealth will provide recommendations and decision support to client during this project.
  • GetixHealth will make recommendations and advise when client representatives should attend direct meetings with payer.
  • GetixHealth will copy emails and correspondence to client.
  • This process usually takes a maximum of 10-15 hours but may be increased dependent on the length of the negotiation and number of payer-client exchanges.

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Follow-up & Support

GetixHealth may take the following ancillary steps where requested by the client:

  • Detailed fee analysis of payer impact on top procedure codes.
  • Review of provider manual references and content for administrative impact on client.
  • These services are billed at an hourly rate.

Client Responsibilities

Clients do have specific responsibilities during contract activities:

  • Providing competing payer contracts where applicable
  • Providing prior payer contracts where applicable
  • Providing top procedure codes and fees
  • Contacting and confirming any additional conditions of confidentiality with the payer

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