Managing the various agreements and documents for your medical practice, such as payor contracts, credentialing, and vendor contracts for EMR systems, is one of many challenges facing medical practices today. Without a process in place for effective contract and document management, your practice could be open to compliance risk.
We recently had a client who had to let go of their previous administrator and billing manager for various reasons, one of which was the fact that neither were keeping track of credentialing and insurance payor contracting documents effectively. When our client hired their new administrator, she arrived to find some providers were never credentialed properly and no documentation or history information was readily available about the payors they are contracted with.
To quickly get their contracts assessed and managed, we spent time directly contacting all payors in the market to get current copies of the contracts, allowing us to determine which plans the client was in-network and out-of-network with. We also helped the new practice administrator get all the providers covered under the payor contracts and set up notifications for the providers’ re-credentialing dates to make sure their status didn’t lapse in the future. The whole undertaking could have easily been avoided with an effective contract management process.
To make sure your contracts are being properly managed:
Create a system for your contract management process
For many healthcare organizations, the contract management process may be manual or unnecessarily complex requiring many people in the practice to touch a contract. Some of the steps in the process may include an initial request, reviewing the agreement, corrections, approvals and final document storage. Establishing a clearly defined process for each agreement and contract type will create efficiencies and ensure compliance.
Using a documented workflow is the first step in contract management best practices.
A well-implemented workflow system allows an unlimited number of processes and steps to address any medical practice need. With a more efficient workflow and standardized processes, your practice will be able to easily identify the status of the contract as it moves through the system.
Leverage role-based security based on your practice requirements.
Using contract management software to automate the process allows for role-based security. A practice can identify specific users, their roles, access and permissions required for effective contract and agreement management. These security practices provide your compliance officer the information and assurances necessary for monitoring a user action.
Consider contract management reporting for ongoing monitoring.
Easy reporting allows your practice to review the status of agreements and contracts. Using an automated contract management tool enables the practice to create reports with criteria from any field in the system. With an export and print function to Excel (CSV) and PDF format, the contract and agreement repository becomes a powerful reporting tool. A best practice is to identify a group of standard reports to run regularly to effectively monitor your contract management system.
Meet the Author
Payor Contracting Specialist
Aldrich Core Conulsting LLC
Courtney Stevenson joined Aldrich in 2018 and has eight years of experience in the healthcare industry. Courtney has worked extensively with both insurance providers and physicians: prior to joining the firm, she managed a provider relations team at a nationwide insurance company and coordinated member services for a large health plan provider in Oregon. As…
- Payor contracting
- Healthcare contract management
- Healthcare finance