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It Took Two Decades for Private Payor Contracts to Erode the Bottom Line: Comeback Part V

It Took Two Decades for Private Payor Contracts to Erode the Bottom Line: Comeback Part V


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This last article in the series offers some final contract provisions that if accepted “as is� in the payors’ or networks’ proposed agreements will afford the payers with too much control over key financial, administrative, and clinical issues related to serving patients covered under the contract. Among those discussed in this article are: medical necessity, confidentiality, term/termination/evergreen, favored nation, products to be included in the agreement, EOB and ID card identifiers, and “drafted jointly� issues. You may not win on all of these, but to not request these changes is an implied acceptance of the agreement terms, perpetuating the unfairness.