Common Managed Service Organization Contracting Issues



Identifying Managed Service Organization Contract Concerns

Managing multiple contracts with varying payer preconditions can often overwhelm providers and even provider organizations. Overseeing and managing the entire contracting process is a complicated task with several critical factors in play. Here are some of the factors that you need to consider:

The Healthcare Contract Agreement Process

Healthcare providers do not often have a standardized negotiation process in contracting with payers. Your position as a managed service organization is to help healthcare providers systematize their contracting process. When done incorrectly, there will be clear issues with compliance, inefficient administrative procedures, and lower reimbursement rates.

The Quality of Internal and External Communication

The entire process of negotiating the healthcare contract has multiple aspects to be considered. Similar to playing a game of chess, you need to clearly address dozens of moving parts and pieces. During these discussions, internal and external communication can encounter challenges. Common communication concerns include lack of transparency from both sides, with each angling for its own interest rather than compromising.

The Presence of Unclear Terms and Conditions

Provider contracts can become filled with confusing terms, confusing fine print, and industry jargon. All of these can cause healthcare providers to find the contracts difficult to comprehend. Unclear terms and uncertain conditions can include complex legal terminology, network requirements, and fee schedules among others.

The Categories and Varieties of Healthcare Contracts

Providers juggle with an array of contracts with different payers under different terms. As a managed service organization, your role is to help providers categorize and organize their contract portfolios. This can make the entire process time-consuming and tedious if done incorrectly.

Addressing Healthcare Contracting Challenges for Provider Clients

Your managed service organization needs to determine several factors that affect your provider clients. To better manage the healthcare contracting concerns that your provider clients face, here are some considerations:

Streamline Your Healthcare Negotiation Process

Your contracting process should follow a defined system that is suitable for all your provider clients, and not just one. The following components should be present during the entire discussion stage: the initial request, the agreement review, the corrections, the approvals, and the final documentation and storage.

Increase the Quality of Your Internal and External Communication

Communication is inherently important to any organization as business relationships can easily thrive or suffer, depending on their communication techniques. Your organization should be able to anticipate and address internal and external communication concerns. By creating transparent modes of communication, it allows healthy, open, and trustworthy business relationships all throughout your network.

Clarify Contract Terminologies, Conditions, and Requirements

Along with communication, the clarification of uncertain word usages and terms is extremely important in contract negotiations. As a managed service organization, you protect your healthcare provider clients by helping them understand their contracts clearly. Legal jargon, financial terms, and dispute resolution process are just a few of the conditions that need your negotiating clarification.

Organize and Standardize Healthcare Contracts

Providers can get overwhelmed with the various types of healthcare contracts. Your role is to help them understand, manage, and systematize their contracts. Depending on their category, they can file contracts under fixed term, evergreen, fee-for-service (FFS), and other designations. By providing a systematic process of organizing their contracts, you help healthcare providers focus more on service delivery.



Optimize Contracting Processes with Applied Technology

Healthcare contracts are extremely essential when it comes to patients, providers, and payers. An efficient contract management system can be a huge determining factor in the success of a managed service organization. By helping healthcare providers streamline their contract negotiations, your organization maximizes their service delivery. Healthcare providers can now provide the best possible care, reduce operational costs, comply with regulatory requirements, and mitigate all potential risks.

At MedVision, we believe in empowering healthcare providers and supporting healthcare organizations. Our QuickCap 7 (QC7) aims to elevate your healthcare contracting processes seamlessly. Your organization gets to experience smooth transitional workflows since QC7 also functions effectively as your:

• Physician referral and authorization management
• Provider enrollment and credentialing administration
• Complete claims processing and adjudication workflow
• Comprehensive communication software solutions

QC7 functions as your intuitively customizable integrated value-based healthcare solutions. Experience powerful automated workflows personalized just for your organizational needs and requirements. Reach your targeted healthcare objectives and let QC7 guide your organization towards increased business efficiency and productivity. 



Discover how QuickCap maximizes your operations.