1. How can GM&A negotiate better rates than the large
carriers?
GM&A has industry insiders. Michael Jenike
(former Hospital Administrator) and Dr. Herbert
(former hospital Chief of Medical Staff) negotiating on your behalf.
They know, from being on the other side of the desk, that providers
are willing to give their
BEST rates to employers who are willing to have a direct, multi-year
contract.
2. What TPAs do you work with?
We will work
with the TPA of your choice as long as they are willing to cooperate
with us in your best interest. GM&A can evaluate and recommend a
TPA for you on request.
3. Can we keep our current network?
Not as you know
it. We will be creating a custom network for you. Your current
provider utilization will be a factor in the creation of the new
network.
4. What is the disruption?
As little as possible. We will start the process by looking
at the providers your employees are currently utilizing.
Generally, when the negotiations begin, the providers
who are currently receiving the highest utilization will be the
most competitive.
We will contact and try to negotiate with individual physician
providers at the request of any member. New physician providers can
be added at any time to your custom network.
5. How does GM&A get paid?
At the
beginning of the process, GM&A and the client agree on a benchmark
cost per member per month.
Cost Per Member Per Month = Medical claims dollars paid out of the
plan for the month ( Dr.&Hospital claims) divided by the total
number of covered lives (employee+ spouse + each child)
GM&A will receive a percentage of the true reduction in cost.
6. Who manages the contracts?
GM&A /
DirectNet (see #7answer).
7. Are the agreements between GM&A and the provider?
The agreements
can be between your company and the provider or between your company
and GM&A’s wholly owned subsidiary, DirectNet , which can be the
holder of the provider agreements on your company’s behalf.
8. Does GM&A do credentialing?
Yes
9. How does GM&A get our cow out of the ditch?
Please visit Our Process page
for more answers.
10. Have other questions to ask our staff?
Visit our Question page.
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