Managed Care Contracting

As the health care industry shifts from a volume payment methodology to a value payment methodology, strengthening ties with managed care organizations will become even more critical. With Corrigo’s guidance, clients strengthen their relationships with managed care organizations and realize increased annual revenues. Corrigo has worked with health care systems, hospitals, ambulatory care facilities and physicians to negotiate contracts in all 50 states and with many of the country’s leading managed care companies including United, Aetna, Cigna, Humana, Kaiser Permanente and over 40 Blue Cross Blue Shield Plans.

To ensure all available revenues are captured, Corrigo facilitates the implementation of internal protocols and processes to identify patient coverage, satisfy pre-authorization and utilization management requirements and follow up on underpaid and/or denied claims. Corrigo has one of the industry’s largest managed care data bases containing detailed contract, payment rate, member responsibilities and payment protocol information and uses it to reference and apply the most current approaches for supporting client needs.

Our clients have realized hundreds of millions of dollars of additional revenues from payment rate increases, prior period settlements, and new contracts.

Corrigo’s managed care contracting services include:

  • Direct Negotiation & Negotiation Support
  • Contract Language Reviews
  • Market & Payment Rate Analyses
  • Operational Assessments & Implementation Plans
  • Claims Denial Management
  • Provider Credentialing