Provider Network Development

MERCURY ADVISORY GROUP

a fully-owned subsidiary of Mercury Healthcare International, has been assisting healthcare providers that seek to contract with insurance companies, HMOs, PPOs, and ERISA and Taft-Hartley self-funded health benefit plans through integrated provider networks (IPAs, PHOs, MSOs, ACOs, etc.) since 1991.

All our team experts have both payor and provider contracting experience and more than 15 years of professional work experience in hands-on contract analysis and negotiations. Most have more than 20 years on the job.

Our clients include:

  • Physicians
  • Dentists
  • Therapists
  • IPAs
  • PHOs
  • MSOs
  • ACOs 
  • Physician-Hospital Co-Ops
  • Integrated health delivery systems

 

Operational Challenges

Integrated provider networks call on our experts to help them with a number of operational challenges that arise as they attempt to manage risk for health outcomes and provider reimbursement. These include, but are not limited to the following areas of concern:

  • Contracting with payers and providers, including post-acute providers and facilities, pharma, mental health, telehealth, and DME/HME
  • Actuarial considerations for risk based contracts
  • Necessary data interfaces
  • Best practices for patient education and chronic care management
  • How to develop your own clinical protocols based on population health needs of your specific lives and their health needs

We devise solutions to help physicians, dentists, therapists and network managers operate efficiently and contract for better reimbursement terms.  We adopt existing core concepts from Milliman, Johns Hopkins and other published sources and adapt them to your unique network providers and the patients you've been assigned.  No two networks are ever the same in terms of what to do and how to do it best. This is because no two networks have the same patients, the same resources, or the same population health dynamics.  

IPA, PHO, MSO & ACO PROVIDER NETWORK DEVELOPMENT SINCE 1991

Network Planning and Development - Market Penetration - Contract Amendments - Renewals - Operational Improvement - Population Health Management

market research for emails that sell like hotcakes

HMOs - PPOs - INSURANCE COMPANIES - SELF-FUNDED EMPLOYERS - LABOR UNIONS - HEALTHCARE PURCHASING GROUPS

We develop and create healthcare provider-networks and prepare them to contract directly with payors through performance based reimbursement, case rates and capitated risk sharing arrangements

We bring network development consultants, credentialing and privileging experts, epidemiologist physicians, former health plan medical directors and network managers to the table instead of using recent graduates that would cost the firm far less. In fact, we don't hire recent graduates. With Mercury Advisory Group you receive the guidance you need from our team of seasoned experts with decades of practical, hands-on experience.  

Access the experts you need when you need them the most.

Contract Analysis

Full service consultation is available to help you analyze contract offers and develop counter-proposals or identify necessary changes to protect you from ambiguous terms and provisions that lead to payment delays and denials.

Negotiation Assistance

We negotiate on your behalf if you lack the time or expertise to negotiate on your own. Alternatively, we shadow coach your team throughout the entire negotiation proceedings so your team appears as seasoned expert negotiators.

Payment Models

We assist with analysis and negotiation of any payment arrangement -- including, but limited to: performance-based contracting, shared risk, full risk capitation, case rates, and more.

Market Penetration

If you recently formed and need to secure new payor contracts, we handle the market research, book of business analysis, due diligence, and other pre-contracting activities you'll need to grow and sustain your network.

MERCURY ADVISORY GROUP CONTRACTS FOR MANAGED CARE SERVICES ON AN HOURLY FEE AGREEMENT BASIS WITH AN ADVANCE DEPOSIT ON ACCOUNT

Upon request of our clients, Mercury Advisory Group experts assist clients with telephone or onsite consultation, outsourced contract review and recommendations for counter-proposals and modifications to protect them from unnecessary risk of payment delays, denials and costly administrative burdens. We can negotiate on your behalf or shadow coach you behind the scenes until you are comfortable doing it on your own.  

Each third-party payer or plan administrator selects its own short-list of qualified providers according to its company priorities and plan design for its employees, executives and retirees.  All costs associated with our services are borne by the provider.  Our charges do not imply any guarantee of success or preference by insurers, provider networks, HMOs, PPOs, or self-funded employers and labor union plan administrators.

 

Annual Client Contracts Managed Since 1983

Medical, Dental and Surgical Services, Rehabilitation, Diagnostic Exams, Consultations, Home Care, Telehealth, HME/DME, Pharma and Device Manufacturers

Consultation is available to help provider networks prepare for success with third-party payment contracting  and reimbursement strategies or to plan for contract amendments or deal with provider "lockouts" throughout the USA and 120 countries worldwide.

Find Out More

Call +1 (800) 727-4160 to learn more today

Come Visit Us In Denver

600 17th Street, Suite 2800-S
Denver, Colorado 80202

Or we can come to you

 

Mercury Advisory Group

Under the direction of Maria Todd, author of IPA PHO MSO Development Strategies, and Physician Integration & Alignment: IPA, PHO, MSO, ACOs and Beyond. Ms Todd has developed more than 400 provider networks throughout the USA and abroad since 1993.
Physician Integration Book