Physician WebLink provides a full range of services related to the design, formation and maintenance of a managed care delivery network. We can provide time and money-saving solutions for groups as small as a fee-for-service single specialty, or as broad as a full service, capitated network including physicians, hospitals, and all necessary ancillary providers.
On behalf of its client, Physician WebLink will solicit and negotiate health plan contracts for providers and provider systems. This includes both risk (capitated HMO) and non-risk (fee-for-service PPO) contracts.
PWL will then administer, maintain, and renegotiate contracts as necessary. Service highlights include:
Financial analysis and modeling prior to negotiation
Review and recommendations related to contract language and terms
Scanning and electronic filing of all contract documents to ensure secure storage of master documents while allowing for appropriate on-line access by authorized personnel
Establishing a network of contracted providers is the foundation of a managed care deliver system. Our staff has extensive experience and a proven track record in provider network development. Contracting is done primarily in the field via personal face-to-face interactions. Service highlights include:
Identifying and developing physician leaders
Establish provider coverage needs and conduct an adequacy analysis
In addition to fee-for-service rates, development of unique payment methodologies such as zero-based budgets, case rates and capitation
PWL will develop and administer a credentialing process for clients’ contracted network of providers to the National Committee of Quality Assurance (NCQA) requirements. Service highlights include:
Verification of information from malpractice carriers, state licensing boards and National Practitioner Data Bank
On-site audits of provider office for primary care physicians and high volume specialists per NCQA standards
Arrange for and facilitate credentialing committee meetings for client organization
Keeping your network informed of the current administrative processes and resolution of any issues is critical to maintaining a satisfied network of providers. To fulfill this need PWL staff understands the value of building close relationships with the physicians and their office staff. These services include such things as:
Development and distribution of provider manuals
Conduct new provider orientations and ongoing re-education as needed
Train provider office and health plan staff to use Practice Connect® for secure internet-based communications
PWL provides dedicated staff using a state-of-the art ACD phone system to assist enrolled members with questions and issues. Service highlights include:
Tracking and trending of call statistics such as volume, time of day, wait times, speed to answer, abandonment rate, and reason for calls
Specialization in the needs of senior health plan members
Availability of multi-lingual staff and translation services when needed
