Provider Network Contracting and Revenue Management

Our provider network management practice will 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 to determine where unnecessary medical losses may be occurring, and make recommendations for improvements.  We can also assist with developing and implementing physician pay-for-performance initiatives.

Whether you are developing Medicare provider networks for the first time, or already have them in place, Gorman Health Group’s Medicare provider network contracting and revenue management services are designed to create efficiencies to help your plan reduce overall costs and enhance revenues.