Taking command of payer contracts and thoroughly understanding their implications is essential to the success of a physician practice. Protect your practice from inappropriate payer discounts by understanding the implications of contract provisions.
The fourth edition of the American Medical Association's (AMA) "Model Managed Care Contract" offers a reasonable alternative to the one-sided, take-it-or-leave-it contracts physicians typically receive from health insurers. The model contract includes 10 supplemental discussion pieces on a range of important issues, including medical necessity/external review, "all products" provisions, and the restrictions and obligations that can occur after a contract is terminated.
Visit the AMA Private Sector Advocacy website to access the AMA "Model Managed Care Contract" and other educational resources, such as "15 Steps to Protect Your Practice from Unfair Payment Practices."
As a physician, you know there is strength in numbers. The AMA helps all physicians, regardless of specialty or practice setting, speak with a unified voice on the most important issues facing medicine. Please encourage the physicians in your practice to join or renew their AMA membership via the AMA's website, or call (800) 262-8335.