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Textbook of Urgent Care Management

Chapter 22, Health Plan Contracting


The Textbook of Urgent Care Management is now offering individual chapters for sale. The full book, provides an expert business consulting guide to potential or existing urgent care clinic owners, managers & operators as well as investors. Learn how to more effectively run your immediate care or walk-in center as well as start incorporating urgent care services into your existing primary care practice. The chapters cover valuable information from industry experts on how to start, manage, and even sell your urgent care center. Chapter 22 includes: Preparation for Contracting - Gather Information About the Health Plan, Payment Methods, and Reputation - Be Familiar With the Various Payment Models - Establish Center Objectives and Determine Leverage in the Marketplace Contract Review and Establishing Action Points - Affiliates - Arbitration - Capitation and Carve-Outs - Clean Claims and Claims Provisions - Covered Services - Credentialing, Eligibility and Verification - Evergreen and Renewal Provisions - Indemnification and Mutual Liability - Medically Necessity - New Plans and Product Lines - Policies, Procedures and Obligations - Professional Liability Coverage - Termination Without Cause - Unilateral Modifications - Negotiation Contract Follow-up