Skilled Nursing Facilities, Home Health Agencies, Specialty Physicians, Hospice agenices, DME companies, et. al.
Mix Solutions was established to provide expert Contract Negotiation services to healthcare industry clients. Mix Solutions’ associates are industry veterans who bring precision, dedication and professionalism to their work. We leverage our relationships with major Health Plan companies to optimize Managed Care contracts for our clients.
Our success comes from established relationships with major health plans, knowledge of market rates and familiarity with HMO processes.
Call 1 (844) HMO-PROS or fill out the online form on the “contact us” page. We will set up a 20 minute FREE consultation for you and then a Consulting Strategy Session to dig deeper into your specific location and facility.
That depends on what state and county you live in, what health plans are in the networks. Mix Solutions knows exactly which health plans are in your state and county or region, and we will help you obtain the best possible rates on those contracts.
Again, that depends on the health plan, but Mix Solutions has experience with many health plans across the nation and we have a credentialing department in place, known contacts with the health plans and great customer service. Due to our connections with those health plans typically using Mix Solutions will be much faster as we know exactly what docs are required, can check to make sure your documents are correct and up-to-date to save time and rejections, and as Mix Solutions contracts are always prepared correctly, our contracts tend to get moved to the front of the line.
The health plan needs will vary, and some need different documents than others. No matter what though, you will always need to have a W9, facility license, survey from Department of Health Services/CMS, and a COI.
Yes. Check with every health plan what the timelines are ahead of time. They vary with each health plan so be careful to make sure you read the contract carefully. Mix Solutions will let you know these timelines when we prepare contracts for you.
NO! Please call to talk to a Mix Solutions consultant about this question! You could be losing a lot of money on every patient if you do not pay attention to this.
This varies, but typically, if you have submitted a “clean claim” meaning all codes/levels are correct etc., then you can expect payment to be about 45 business days after they receive the claim.
Sometimes. Our rates are set based on how many contracts you need, how many facilities you have, what other services are needed etc. Obviously the more contracts you need, the lower the cost per contract, and if you use the Red Carpet Services, this is by far the best value for money. You get all Mix Solutions services included at a discounted rate.
No. In fact, our clients say we have extremely reasonable rates, the ROI is typically very fast as we recover on average around $630 per claim of missing or unbilled revenue.
Mix Solutions always negotiates the best possible rates, and have extensive knowledge on all market rates, so we know a great rate when we see one, just as we recognize a bad deal and will “go to bat” for our clients in those cases.
A Mix Solution’s Case Manager will assist in developing a customized case management system that works specifically for your facility. Case Management training will educate key staff on managed care best practices identifying key components of health plan contracts and how to set up payment and tracking systems. Contracts need to be used to their maximum potential to maintain margins to ensure payments are submitted and collected to the fullest and in the quickest time possible.
An LOA is a Letter of Agreement. If you have a patient who is on a health plan you are not contracted with, you will need an LOA to get paid. You will need to receive this approval from the health plan prior to accepting the patient. If you need help to obtain an LOA, Mix Solutions can step in and advise.
You must join a health plan’s network to receive payment. This means going through credentialing process and negotiating/signing contracts.
No. With the health plans this can be different yet again. Some health plans are giving 11 days, some 30, some a different amount. Check with the health plan to be sure.