LTC Contracting’s Managed Care Authorizations department was founded because of the trend of more patient enrollments in Managed Care plans, as well as more states beginning Managed Medicaid for long term care. Our clients began experiencing severe cash flow due to poor coordination and the constant ongoing need of the case management. LTC contracting proprietary case management software has allowed us to develop a process that can both maximize the reimbursement levels of ST admissions, as well as manage the ongoing Long term residents seamlessly.
- Full case management for all Insurer types. Compiling all clinical and treatment records, submitted timely for all extensions.
- Daily review of all census activity
- Evaluation and comparison to Insurer contract level of care allowances, to advise on Insurer limits and maximization of reimbursement.
- Weekly UR reporting and updates
- Coordinating discharge and long term stay conversions
- Specializing in CHOW – Ensuring each resident is on the appropriate level of care, with an active authorization and proper plan in place.
LTC Contracting utilizes a secure online based portal that monitors each authorization and analyzes each patient extension against their individual Insurer contract criteria. This leads to accurate levels and extension requests, as well as maximization of each insurer’s allowances. The software documents all activity and saves time when working with case management to enable quicker turnaround.