MCCA assigns our clients an experienced managed care liaison, based on geographic location. Every MCCA liaison has relevant experience and understands the challenges healthcare providers face when dealing with multiple insurance plans. Liaisons assist with staff training on managed care processes, with managing issues that might arise in obtaining authorizations or appropriate level of care determinations, and with advocating for case management or claims processing matters.
Solutions
Staff Orientation and Education
As part of the MCCA network, your managed care liaison works on-site to educate your team in individual, group, or regional settings, spending as much time as needed to ensure value with your contracts. Providing managed care education to new members of your team is a key support service.
Systems Review
MCCA works with operational teams to develop and utilize “best practices” for the day-to-day implementation of internal managed care systems. Medicare advantage plans often require different strategies and processes for delivery of care as compared to traditional Medicare. MCCA helps your organization optimize utilization and reimbursement under the terms of your contracts which can vary significantly among the health plans.
Health Plan Audit Support
Most health plans now routinely audit quality of care and services provided, as well as the documentation to support the billing for it. When audits are conducted, MCCA is there to guide your team from beginning to end, providing advice, reviewing findings, and assisting with appeals when appropriate.
