Managed Care Contracting
How confident are you that you are getting paid fair market value for your services?
At Blue & Co., our team utilizes a six-step process to provide support throughout the entire contract review process. From reviewing your contracts, to developing a negotiation strategy, our team of experts are here to make sure you get paid what you should.
Meet our Expert
Kyle Tobbe, a Manager on the revenue cycle team, has over ten years of experience within the Managed Care Contracting world. He has experience with financial modeling, reimbursement methodologies, claims processing systems, and contract negotiations. He is a statistician by training that has leveraged that skill set to create value in managing provider contracts.
1. Guardrail Development
2. Payor Matrix Development
3. Score Matrix Against Guardrail
4. Develop Negotiation Strategy
5. Negotiate Contract
6. Update Matrix and Guardrails
For more information on this process, please fill out the form below to download our pdf handout.
We have a short PRF update this week as the ARP Rural application deadline approaches. Reminder: The application portal closes at 11:59 p.m. on Tuesday, October 26. Before you can fill out and submit your application, your organization needs to validate or revalidate your TIN. HRSA says it could take up to 4 days, but […]
We are two weeks away from the deadline to submit your Phase 4 and ARP Rural Payment Application. These applications are due on October 26. If you haven’t started the process yet, please do so this week. Part of the application involves validating your Tax ID Number (TIN) with the IRS, and HRSA is saying […]
Pursuant to KRS 205.640 and managed care contracts, Kentucky Medicaid Managed Care Organizations (MCOs) are required to provide a Paid Claims Listings (PCLs) to all in-state hospitals. The department and each Medicaid Managed Care Organization shall supply a Paid Claims Listing (PCL) to each hospital within ninety (90) days of the last day of the […]