MCA Consulting

Let us help you negotiate and manage your contracts.

Managed Care Contract Benchmarking

Consulting clients may take advantage of MCA’s professional staff and the powerful modeling capabilities of the AllPayor® system without needing to provide patient claims and remittances. This low impact analysis utilizes MCA’s standard data set of claims, remittances, and contract models to identify potential opportunities to aid in contract negotiations.
The deliverables from this engagement include:
+ Identification of contract provisions that offer new opportunities or could become problematic.
+ A comparison of contracting “best practices” to similar payor contracts.
+ Recommendations for improving contract performance.

Contract Specific Negotiation Support

This consulting service is specifically tailored to hospitals who are interested in taking a more exacting and aggressive approach toward contract negotiations. To initiate this service, clients will be required to provide claim and remittance information (ANSI-837 and ANSI-835, or similar), along with the information necessary to accurately model the contract.
MCA’s professional team will load the hospital data into the AllPayor® system, model the contracts and provide a detailed analysis of the individual contract provisions.
The deliverables from this engagement would include:
+ Detailed reports and recommendations to be used in contract negotiations.
+ As contract changes occur, MCA will rapidly change the model and provide new reports.
+ MCA professional will also be available, if desired, for conference calls between the hospital and insurers to work out new provisions or adjust old provisions.

Ongoing Contract Monitoring

This consulting service incorporates all of Contract Specific Negotiation but adds the opportunity for clients to monitor contract performance on an ongoing basis. It requires period feeds of claim and remittance data for the specific insurers. MCA staff will maintain the contract models and run the overall operations. There would be no need for clients to access the system unless desired.
The deliverables from this engagement would include:
+ A periodic report package will be prepared and provided to the hospital. The frequency and distribution of these reports will be determined prior to initiating the engagement.
+ Insurer offers for new contract terms can be rapidly modeled and impacts identified during contract negotiations.
+ All the deliverables from Contract Specific Negotiation support are also available.