Complimentary half-hour consultation with a managed care expert.
Take advantage of this new member benefit. Exclusively for members of our community.
Receive a complimentary half-hour consultation with one of our managed care experts when you enroll at the annual level.
Are you a Consultant?
The Managed Care Institute welcomes Expressions of Interest letters from consultants, coaches and trainers who would like to offer their services as an expert. Whether you offer contract analysis or specialize in some other area of managed care ( a niche specialty, coaching or training) we invite you to join our coaching team. You must have at least 15 years of verifiable practical experience and an advanced degree in Health Administration, Finance, Business, Law, Marketing, or another related field. Ideally, you will have both payer and provider work experience.
Meet the Team
Maria K Todd, MHA PhD
Managed Care Expert / Director - Managed Care Institute
Maria is the author of the Managed Care Contracting Handbook, 2nd edition and 15 other commercially-published, peer-reviewed professional books in integrated health delivery systems, physician employment contracting, concierge medicine practice startup and medical tourism. She is a 5-time recipient of the HFMA ANI Distinguished Speaker award for her training courses and workshops on managed care contracting.
This space is waiting for you!
Managed Care Expert
You must have at least 15 years of verifiable practical experience and an advanced degree in Health Administration, Finance, Business, Law, Marketing, or another related field. Ideally, you will have both payer and provider work experience.
For medical groups, getting paid for quality patient care is always the priority, but without profitability and efficiency, that goal is often unsustainable. By negotiating better reimbursement agreements with employers, unions and insurers, you'll have an easier time raising reimbursements, and reduce problem claims, short paid claims and delays in payment. You'll also enjoy new ways to market your brand of healthcare and services to sustain practice growth and bring in new and repeat patients and referrals.
We publish articles on LinkedIn's Pulse with tips about increasing provider reimbursements and negotiating better contracts with fewer land mines and oversights that open your reimbursement to avoidable financial, reputation and brand risks.
AskMariaTodd to Manage Your Most Critical Managed Care Contract Analyses and Negotiations
Maria leads a team of seasoned managed care contracting experts with decades of experience from both the payer and provider side of the negotiation table. Take advantage of this affordable and effective alternative and avoid hiring a full time staff member with less experience. We can work on an as-needed basis focusing our efforts on the top 5-7 contracts that are critical to your business. We accept client assignments on the following projects:
- Contracting Proposal Letters and Outreach: Are you new to the business of healthcare? Do you need contracts with payers? Are you feeling a little anxiety about reaching out personally to let payers know you are open to new business? Often the best approach is to send a letter of interest to the plan(s) you've targeted to indicate your interest and explain your brand value and how your practice philosophy aligns with their publicized goals and agenda. We know what to say, how much to say, what you should emphasize, and to whom your correspondence should be directed. But before we write a carbon copy letter that relegates you to a commodity, we take time out to learn about your brand value, benefits to the plan and your situation. This includes a review of your unique service benefits, product
benefits, geographic coverage, social media rankings, references from other providers, business owners and patients, outcomes, CAHPS/CAHPS-CG scores, and other clinical benefits you deliver.
- Contract negotiations: Our clients frequently see reimbursement increases of 10%-20% and ROI often exceeds 15X. Don't wait until your contracts are 5+ years between negotiations. It is often very difficult to move the needle on very old health plan contracts that have not been maintained. The payer will be reticent to bring your contract up to market rate all at once because they set (and file) their underwriting assumptions, actuarial projections and premium rate filings two years in advance and won't have the funds in the budget to make drastic changes all at once. Anyone who promises they can boost your reimbursement after years of contract management neglect is probably unaware of these constraints. Yes, it can happen on rare occasions, but that's exception, not the rule.
- Physician reimbursement analysis: We bring our exclusive tools and national contracting information as the benchmark to determine if you are being underpaid against national and regional averages. What we will not do is apply rate information from your direct competitors, because that is tantamount to price fixing by a consultant, which is highly illegal.
- Provider credentialing: We'll manage the process of credentialing new physicians and practitioners at your office and manage your CAQH data along with re-credentialing your current medical staff. We'll handle document management filing, license renewals, hospital privilege letters, and payer follow-up. Call us to get started and learn about our competitive rates for this service.
- Claims management and appeals: Our appeal specialists have both clinical and insurance and specialized ERISA knowledge. Our overturned denials bring in cash when others hit a brick wall. We use a single case agreement (SCA) or continuous discount arrangement (CDA) agreement for one off agreements with case managers or small health plans when full contracts simply aren't warranted or feasible.
- Online Marketing and Referrals: Deploying a combination of email marketing, social media marketing, SEO optimization techniques, and blogging, we can help you grow your patient base, online presence, and continue to build your reputation locally and online.
- Private Coaching: Maria Todd offers private one-on-one coaching, live or remotely. You'll learn our methods for non-confrontational contract negotiation, and pre-negotiation due diligence, as well as how to measure financial performance and manage your contracts better so you are assured success going forward or immediately identify exit indicators with higher confidence.
You are most welcome to send your staff to Maria Todd's Master Classes. Maria Todd has trained more than 60,000 healthcare administrators, managers and executives through national associations and seminar companies, and is the author of 18 industry best sellers on the business of healthcare and third-party reimbursement contracting.
Managed Care Contracting Expertise for Your Practice or Healthcare Organization
We perform contract negotiations for more than 4000 healthcare providers across the USA and abroad. For decades, Maria Todd has been the leading non-attorney go-to expert for high-profile healthcare brands such as Mayo, Cleveland Clinic, as well as pharma, device manufacturers, DME/HME, Home Health Agencies, PT/OT, ASCs and hospitals. You benefit from our decades of experience and hands-on experience in the healthcare, managed care contracting, concierge medicine, physician and hospital marketing and brand value improvement.
Contact us now and let’s discuss how we can assist with your managed care contracting needs.
Advertising on the Managed Care Institute Website
Approved consultants are eligible to advertise their services in our online marketplace. Our online marketplace offers visitors a showcase of products and services from people who can help them. Marketplace products and services include books, insurance, products, training, and professional services. Please don't use the Managed Care Institute's member discussion area or groups to market your services or seminars. Off topic posts or posts that offer little information other than advertising will be removed without warning and poster restricted from future posts without administrator moderation.