HMO Contracting

Amplify your revenue with specialized contract management

Managed care contracts are complex.

What should be a simple transaction of services, is often a long-winded, confusing path.

Are you still receiving the same low rates you received back when you initially secured your contract?

Are you running around in circles trying to procure or renegotiate a contract?

Are you struggling to meet specific credentialing criteria?

You don’t deserve to be pushed around like that.

Procurement and
negotiation by the experts

At Case Management Solutions, we have a professional team on hand, ready to handle your contracting dilemmas.

Payors are notoriously difficult negotiators.
(That’s if you even get to speak to the right person…)

They have a long list of ever-changing guidelines,
and you risk being seriously underpaid if you aren’t in the know.

You are providing care for hundreds of patients each month and you want to expand your network to drive census

You need a robust network + reimbursement in line with your market value.

Having worked in the industry for over a decade, acquiring and negotiating thousands of contracts, Case Management Solutions has the connections and the expertise to manage the negotiation process successfully on your behalf.

“Their knowledge and experience with HMOs has alleviated a lot of the stress…”

“I have been working with Case Management Solutions for the past 3 years and my experience has been great. Their knowledge and experience with HMOs has alleviated a lot of the stress associated with contracting with HMOs and targeting the HMO in each facility’s specific region. The staff are always accessible, professional and they assist us with addressing the specific issues of each facility. Case Management Solutions’ expertise in the HMO world, as I call it, has been extremely valuable to our business.”

Ilana Avinari, CFO

Optima Care

Ready to amplify your revenue?

Here’s how we can help:

Contract Management + Negotiation

Harnessing key relationships and proven techniques, we work alongside your facility to help you:

  • Procure new or previously-unobtainable contracts
  • Renegotiate your rates
  • Manage your data on a cloud-based portal
  • Summarize contracts  for easy reference
  • Stay in the know via regular contract briefings

Working with a start-up facility? 

We’ll review, recommend, and pursue contracts based on our extensive experience and market analysis.

Credentialing / Recredentialing

Essential for uninterrupted patient care, the process of credentialing and recredentialing requires strict adherence to guidelines and deadlines, and takes up hours of your time. 

Our credentialing specialist will help you: 

  • Obtain and manage the necessary data
  • Prepare and submit all relevant applications 
  • Record retention for future reference

Medical Facility Ownership Changes

Dealing with a merger, acquisition, or ownership change involves many unfamiliar responsibilities. With Case Management Solutions on your side you’ll have personalized guidance every step of the way so you can proceed with the process confidently. 

As part of our strategy, we will:

  • Schedule an initial discovery meeting
  • Create a detailed plan of action 
  • Collaborate with key facility staff 
  • Begin the delicate process of notifying insurance companies 
  • Ensure your current rates remain in place via exclusive contract comparisons
  • Finalize new or updated contractual agreements
  • Create guides and summaries for ease of reference for owners and relevant staff members

Government Contracting + Updates

With our dedicated professional and government clearance, we can help you with the following contract-types: 

  • Straight Veteran’s Affairs Agreement
  • Tricare for Life
  • Humana Military or Healthnet Federal Services, depending on service state
  • Veteran’s Affairs Community Care Network (VA CCN)

Ready to join the 300 facility owners who’ve secured better contracts?

There are management teams.
Then, there’s Case Management Solutions.

When you hand over your management to a member of our team, it becomes our personal mission.

We’re a strong-willed, highly skilled group with clear processes in place.
We know that closed doors are irreversible and love transforming struggles into wins.
But more than anything, we know your rights and we fight hard to secure them.

“They successfully got us the contract that was once deemed impossible.”

Using Case Management Solutions was one of the single best decisions our company has made. When we purchased a large CCRC we were told that the one contract we wanted was impossible to get. They had been trying for almost 10 years to no avail.
After only a few months, they successfully got us the contract that was once deemed impossible.
Thank you, Case Management Solutions. I highly recommend them to any of my fellow healthcare operators.

Avi Satt

Sage Healthcare Partners

Amplify your revenue today!