Managed Care Contracting & Negotiation

Hritz Management Services reviews and summarizes key points in managed care contracts and analyzes reimbursement rates by payer for the procedures that make up at least 80% of the practice’s gross revenue. Hritz Management Services’ proprietary tool may be “populated” by most practice management systems, to perform the reimbursement analysis aspect of this work. Hritz Management Services educates providers with this data and works with them to develop an action plan for “problem” payers. Hritz Management Services takes the lead in working directly with the “problem” payers on behalf of the provider, including renegotiating and/or terminating underperforming managed care contracts.

This scope of work often includes the need for Hritz Management Services to develop a managed care “participation grid” for the provider as a day-to-day reference tool for medical office and/or billing staff.


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