PRISM can perform the complete process of conceptualizing, specifying and establishing a specialty network.
Benefits
Ø Take advantage of the trend for payers to outsource particular medical functions to specialty networks.
Ø Utilize experienced healthcare management consultants for turnkey development of a specialty network, thereby not diverting internal staff from core functions.
Ø Determine upfront the scope of the market for a specialty network.
Ø Determine if vendors may be effectively utilized.
Specialty Network Development
Ø Initial conceptualization of the network including purpose, methods and goals.
Ø Specification of the provider network composition – physicians, facilities and ancillaries.
Ø Establishment of appropriate fee schedules.
Ø Creation of provider participation terms and conditions, followed by development of contracts, manuals and marketing materials.
Ø Contract with providers.
Ø Establish conditions and methods of member access.
Ø Identify, contract and coordinate vendors.
Ø Develop marketing plan and lead or assist in marketing.
Process
Ø Client determines the type of specialty network opportunity.
Ø PRISM develops specialty network plan including documents and materials (to be reviewed by an attorney).
Ø Following approval by the client, PRISM commences on developing the network.
Ø PRISM also develops the operational plan for providers and member access.
Ø PRISM develops and executes a marketing plan.
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