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Managed healthcare - Assignment Example

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The first stage is the claims entry stage. The second one is the claims adjudication process while the third is the payment process. This method of…
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Managed healthcare
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Topic: Managed Healthcare How effective I would rate the common contract negotiation strategies practiced by managed care companiesThe main negotiation strategies practiced by the managed care companies is the claims payment which involves several processes. The first stage is the claims entry stage. The second one is the claims adjudication process while the third is the payment process. This method of negotiation is very effective in that it ensures that there is evidence of the transaction in the database and tat each step involved ensures the accuracy of the negotiation strategies.

Through the use of technology, the claims information is entered to the system and recorded. The adjudication process hen ensures that the claim is valid through thorough analyzing. When the claim is found to be valid, then the payment is made and the negotiation is finalized making it a very effective process.What has been the impact of consumerism regarding plan design and network development?Consumerism refers to the promotion of the interests of the consumers. Giving the providers access to more patient information promotes consumerism.

When all activities in the managed care organization are focused on promoting consumer satisfaction, then it is likely that there will be the development of the network. This is because when the consumers-in this case the patients are assured of high quality services, then they will be more willing to be cared for by the particular organization that seems to promote consumerism. They will come up with predictive models in order to identify what the purchasers prefer. The managed care organization will also be focused on looking into the data and information that they have and planning any future actions based on the facts in the data.

These plans will involve upgrades as a result of the attempt to promote consumerism (Robinson 2005).ReferencesRobinson, J. C. (2005). Managed consumerism in health care. Health Affairs,24(6), 1478-1489.ReferencesKongstvedt, P. (2012). Essentials of managed health care. Jones & Bartlett Publishers.

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