Provider Contracts Are Unique, But Your Contracting Process Shouldn’t Be.

Provider onboarding starts with the provider contract. Executing a provider contract—which must comply with federal and state regulations—is more complicated than signing contracts with vendors to purchase gloves or catheters.

Every provider contract includes a variety of different terms detailing highly regulated components of the relationship, such as compensation, bonuses, and tuition reimbursements. To comply with the Stark Law and Anti-Kickback Statute, provider compensation must be consistent with Fair Market Value (FMV) and not take into consideration the value or volume of referrals the provider brings to the healthcare organization. Therefore, you must carefully evaluate the compensation arrangements in each provider contract. Failure to do so can be very costly. One Montana hospital paid $24 million to resolve Department of Justice allegations that it violated the False Claims Act by paying physicians more than FMV and by conspiring to enter into arrangements that improperly induced referrals.

Although provider contracts are unique, your contracting processes shouldn’t be. Standardizing and optimizing your contracting processes promotes compliance and accelerates provider onboarding, so your providers can start seeing patients and getting paid sooner.

How to Improve Provider Contracting

Store electronic provider contracts in a central repository. Paper contracts stored in filing cabinets in multiple departments across your organization are difficult to locate, let alone manage. When electronic contracts are stored in one central database, the people in various departments who are responsible for provider contracting, credentialing, privileging, and enrollment have easy access and transparency to the information they need, without duplicating efforts.

Standardize contracting processes and templates to improve productivity, decision-making, and compliance. Automated, repeatable, permission-based workflows standardize your operations and promote compliance at every stage of the contract lifecycle—from initiation, review, and approval to renewal, amendment, and termination. Custom workflows create transparency and accountability, eliminate bottlenecks, and systematize your decision-making processes.

Standardize contract terms to reduce contract variability that can lead to regulatory violations or financial concerns. Standard forms, templates, and contract language (e.g., clauses related to compensation) minimize that contract variability.

TractManager’s Provider Contracting solution seamlessly integrates with our Provider Onboarding solution, allowing you to reduce your contracting timeframes by 68%. Our Provider Analytics helps you effectively manage provider compensation and comply with regulatory requirements, effectively optimizing your entire provider contracting and onboarding processes.

Read our Guide, The 4 Ds of Provider Onboarding, to discover more strategies to improve your provider contracting and other onboarding processes.

Author:

Kimberly Hartsfield

Chief Data Officer

Kimberly Hartsfield became Chief Data Officer for TractManager in June 2017.

 

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