Guidance Care HMO Information

HMO Contracting Service: Navigating the world of HMO's can be daunting. Our central goal at Guidance Care HMO when negotiating a managed care contract is to ensure that medical providers increase their revenue and cut costs. We are successful in negotiating rate raises and exclusions with HMO's due to our long-standing relationships with them. We handle and track the lengthy application process on behalf of our providers. We Gather the necessary documentation and make sure all data is up-to-date so that credentialing is always completed on schedule. When a contract is prepared for Signature is carefully reviewed by our Contracting team to ensure that the contract language and terminology is in the best interest of the provider. Most importantly, guidance care HMO allows our providers full ownership rights to their contracts. We guarantee a profitable experience by only charging for a success. Liaison Service: Ensures that your managed care residents do not damage your AR by not being screened properly before they admit to the building. It also ensures that potential referrals are not lost due to lack of understanding of the managed care industry. Again, it is through utilizing our relationships with the HMOs and experience in the field to insure your success. Case Management Service: Utilize our admissions/CM department to handle the entire referral process and follow it to billing. We would obtain all of your HMO prior authorizations, as well as handle the clinical updates and hand it over along with all the necessary info to your AR team at the start of every billing cycle. Collections: If you have any old AR that you have written off GCHMO can work on collections for your facilities however old. We have been very successful in finding old monies for facilities that are not even on their aging. In addition, our experience with managed care has helped us work managed care claims that have long been written off as uncollectable. Call us today 732.806.8130