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.
