Managed Care

Our specialized team of experts provides complete managed care support and actively participates in payer renewal and negotiations with above-market outcomes to improve your practice’s bottom line.

CONTRACT RENEGOTIATIONS

We successfully help negotiate contracts nationwide annually with an average fee schedule increase of 10% for professional, infusion, and drug services.

RECOVERY OF FUNDS

Our managed care experts have recovered hundreds of thousands of dollars for our clients through continuous data mining and comparative analysis of paid charges versus contracted fee schedules. We ensure that the practice is paid according to contract rates where insurance companies failed to pay claims appropriately in the past.

RAC REVIEWS AND RECOUPMENTS

Our Managed Care Department lends vast support to our clients when preparing for and responding to insurance company audits, RAC reviews, and other recoupment activity. The services Healix provides assist with medical record review, document preparation, appeal letters, and legal support.

CONTRACT REVIEW

Assisting clients with contract review enables us to detect disadvantageous language such as evergreen terms or amendment without mutual consent.