The benefit to patients is that those who choose to come to Children's Memorial based on its quality of care can do so through these plans. The drawback to Children's Memorial is that it must remain competitive on pricing or patients will eventually choose a lower cost provider. Since its beginning, managed care growth has been a large part of the payer mix of Children's Memorial. Managed Care Contracts at Children's Memorial Click here for a listing of managed care insurance partners , or here for a listing of physician group partners . Both areas work closely with other departments and external entities to maximize reimbursement and streamline operations, while complementing the Children's Memorial Mission.
Operations Provides detailed analyses necessary for successful contract negotiations.
Maintains Pathways Contract Management and other managed care-related information. Initiates revenue enhancement projects in cooperation with Finance and other departments. Contracting Negotiates all hospital managed care contracts, excluding psychology and transplant services. Negotiates settlements with non-contracted insurers at maximum reimbursement rates. Maintains relationships with all managed care payers.