Provider Network Operations
Gorman Health Group’s Medicare provider network contracting services are designed to help your plan reduce costs and enhance provider relationships.
We’ll examine your current physician, hospital, and ancillary contracts and identify elements within these that may not be working to your plan’s full financial advantage – and assist in modifying these terms so your plan can reap the maximum benefit. We can also review your claims payment system for accuracy and adherence to contractual reimbursement terms.
Gorman Health Group’s services can also include reviewing your plan’s current referral, medical management, and utilization management processes. This will determine where unnecessary medical losses may be occurring. We’ll then make recommendations for improvements and assist you in their execution.
Interim Provider Network Management Resources
If you need a temporary provider network manager or interim expertise on launching a new product line, Gorman Health Group can fill in the gap so your organization can maintain close watch over this critcial function.
Additional Provider Network Operational Support Services
- Pay-for-performance development
- HSD table and HSD database program development
- Electronic medical record consulting
- Outside vendor evaluation and selection (ie, claims, credentialing, etc.).
