Question

What are the appropriate contractual agreements on the hospital

Answer 1

Payer contracts define and explain a provider's reimbursement arrangement for delivering healthcare services to patients covered by a specific health plan. The contracts cover everything from reimbursement rates and provider networks to medical necessity and provider credentialing.

Here are seven general sections that should be included in any contract between an independent contractor and client.

• Statement of Relationship.
• Project Description.
• Payment and Billing Terms.
• Responsibilities of Each Party.
• Project Timeline and Deadlines

Contracts are essential documents in all industries and healthcare is no exception. An efficient contracts management system allows healthcare organizations to provide the best possible care to patients, reduce operating costs, assure adherence to compliance requirements, and mitigate risk.Implied contracts between physicians/patients are contracts that do not set a course of action or payment at the beginning of service.

5 tips to negotiate favorable payer contracts

1. Focus on payers that consistently pay below the Medicare fee schedule amount. ...
2. Create a value proposition
3. At a minimum, ask for a cost-of-living increase.
4. Don't forget ancillary services.
5. Involve your coders.

The 5 Elements That Constitute a Binding Contract

• Offer.
• Acceptance.
• Consideration.
• Mutuality of Obligation.
• Competency and Capacity.

The healthcare industry has one of the largest and most tedious paperwork loads of any industry. A substantial portion of that paperwork doesn’t have anything to do with medical information, but instead has to do with managing contracts and other types of legal documents. In this article we’ll go over some common types of contracts and agreements, the relevant regulatory entities and laws, and some best practices to modernize healthcare industry contracts.

Types of Contracts

There are different varieties of contracts are available.it includs

Physician Employment Contract

A physician employment contract is an agreement between a physician and a hospital, with the physician agreeing to work as an employee of the hospital. Things included in a physician employment contract are compensation, benefits, schedule, terms of termination, and restrictive covenants. A restrictive covenant address things such as, in the event of termination, will the physician be able to continue practicing in the area.

Physician Recruitment Contract

A physician recruitment contract is related to, but distinct from a physician employment agreement. In recruitment agreements, a hospital or other healthcare provider lays out the terms of recruiting a physician to come work for them. Typically, a recruitment contracts are laid out specifically to stay in compliance with federal Stark laws, which deals with the handling of referrals. If hired,

Management Services Arrangement

Management services agreements are used to outsource the management of certain administrative and support employees to a third-party management company. Additionally, in most cases this management company is also in charge of the upkeep of the physical offices and equipment. Workers such as medical practice administrators , clerical/secretarial, bookkeeping, and collections personnel who do not perform a direct medical function are placed under the management company.

Medical Directorship Arrangement

A medical directorship arrangement is a role that a physician may enter into that is more closely related to the larger policies and administration of the healthcare provider they work for than a normal physician would typically fulfill. Though there is some variance in the specific types of tasks the director may fulfill, there are some common features. A medical director may be involved with policy development, promoting best practices, and providing training. With a medical directorship though, comes the need for compliance with Stark Law and Anti-Kickback Statutes. The office of Inspector General (OIG) along with the Department of Justice are taking initiatives to investigate any possible non-compliant arrangements. At its core, the Anti-Kickback Statute forbids medical directors from making payments in the form of remuneration in exchange for referrals or to attract business that is paid for by federally sponsored healthcare programs.

Transfer Agreements

In the medical field, a transfer agreement is a written agreement between two separate healthcare providers for transferring a patient from one to the other. A fairly straightforward document, a medical transfer agreement is nonetheless a legal document requiring witnesses and signatures, and needs to be compliant with specific laws. In a typical medical transfer agreement, terms (length of care), terms of termination, duties, and insurance information are included. Also, liability issues, billing, governing laws, access to records, and free choice and medical judgement sections are usually included.

Contract Management Software

The many different types of contracts related to the medical field, all of which need to meet regulatory requirements and maintain a certain degree of compliance, can create a difficult and tedious situation to navigate. Contract lifecycle management platforms make handling these types of contracts easier, more simplified, and more intuitive than ever before. With Concord, you can perform e-signatures and e-negotiations, as well as review, share, and edit contracts from literally anywhere with an internet connection, anytime.

Technology Licensing

Hospitals are the home of some of the world’s most advanced technologies, but the process of acquiring these technologies usually means entering into a licensing agreement of some kind. To understand how best to manage licensing agreements, it is important to understand the legal implications that accompany licensing, and they describe a licensing agreement as a relationship, usually spanning only a specified amount of time, and moving toward mutual benefit of both parties.

“It pre-supposes a continuing interaction where the licensor and licensee work towards realizing their common goal, which is to effectively use the technology for their mutual benefit. Assuming that the relationship is successful, and therefore profitable, it would mean that both the licensor and licensee would be financially compensated, usually and primarily in the form of an ongoing incremental income stream on the basis of the success of the product in the marketplace. Licensing, therefore, entails very different legal and practical consequences to those of a sale or assignment.”

Executive Compensation and Employee Benefits Arrangements

Executive compensation plans and arrangements most generally include a wide variety of legal financial, and tax information. An increasingly complex maze of government regulation and market pressures means that we can’t talk about executive compensation without also talking about tax issues, bankruptcy, securities, and corporate governance issues. There are various types of executive compensation and employee benefits types: salary, benefits, insurance plans, stock options, and bonuses. There are several regulatory methods used to keep executive compensation as fair as possible including extending the vesting period and disclosing salaries. Along with all these facets, security is critical. Keeping the executive compensation and employee benefits in a highly secure location will help greatly with avoiding possible liability issues.

Joint Ventures

Joint venture agreements take place between two or more companies, corporations, or individuals. Usually they are short term partnerships that shares profits, risks, and assets as the two entities seek mutual profit. When companies are seeking new technologies or to enter new markets they usually form a joint venture. Partnership contracts and commercial transactions law govern joint ventures in the United States, and are subject to income tax and in some cases, international trade laws. Hospitals may utilize joint-venture agreements as they seek to expand technologically or strategically.

Purchased Services Agreements

Purchased services agreements given to any outsourced, 3^rd party that, instead of working directly for the hospital, work as a non-employee contractor to the hospital or healthcare provider. Many healthcare providers look to purchased service agreements as a way to reduce costs. For hospitals these types of agreements generally go into four categories of contractor: clinical, environmental, support-services, and financial. According to beckerhospitalreview.com, purchased services “can account for up to 35 percent of a typical U.S. hospital’s operating expenses.” When managed correctly and efficiently, utilizing purchased service agreements can help hospitals save substantially, but when poorly managed they can present a serious risk. Great care needs to be taken by the contract manager to insure that the best pricing is secured and all the necessary legal and regulatory requirements are met.

Under Arrangement Agreements

An under arrangement agreement is similar to purchased services agreements in that they both contract with a third party to provide a service to the hospital, but there are some key differences. Healthlawers.org describes several criteria of an under arrangement agreement: “the service provided by the third party under the “under arrangement agreement” is treated and billed like a hospital service. The contracted entity is also paid a fee, often on a “per-service” basis. The hospital’s agreement with the contracted entity must require the entity to look solely to the hospital for payment.” With under arrangement agreements, compliance with Stark Law is also a crucial factor. See the starklaw website for more information.

Equipment Sales and Leases

For the specialized equipment that hospitals require, there are many benefits of arranging to lease, or equipment used, instead of buying brand new equipment which can be very expensive. Some leases of equipment can be considered by the IRS a tax-deductible transaction, is more flexible, speedy, and easier to manage than loans. See healthlthleadersmedia.com for a more detailed report on leasing medical equipment.

Ancillary Services Agreements

Ancillary agreements can vary in terms of content, but they generally encompass some of the following categories: escrow agreements, documents of transfer, and post-closing commercial arrangements.

Supervision Agreements

Interns and individuals involved in a residency program require a supervisor as they gain necessary experience. Having a supervision agreement is critical because it provides some key functions. Solidifies roles and responsibilities, establishes collaborative relationships and boundaries, and a review process. A supervisor agreement is a formal document that provides a backdrop from which to conduct performance reviews.

In addition to the types of legal documents healthcare providers need to store and manage, we’ll also discuss the various organizations to stay compliant with in the handling and execution of formal legal and financial arrangements.

Contract Management Software

The many different types of contracts related to the medical field, all of which need to meet regulatory requirements and maintain a certain degree of compliance, can create a difficult and tedious situation to navigate. To make handling these types of contracts easier, more secure, more simplified, and more intuitive than ever before, use the Concord Contract Management Software. With Concord, you can perform e-signatures and e-negotiations, as well as review, share, and edit contracts from literally anywhere with an internet connection, anytime.