Provider Solutions
MNS is the nation’s leading independent expert in managed care within the skilled nursing environment.
For more than 25 years MNS has helped nearly 5,000 Skilled Nursing Facilities navigate the Managed Care landscape with more than 50 different plans, encompassing thousands of products and providing support to members during millions of covered admissions.
Serving as the link between the payor and the provider, MNS provides a wide range of services including getting facilities contracted and credentialed, maximizing patient admissions and overall occupancy, facilitating authorization of skilled stays, and delivering timely and accurate reimbursement.
Contracting
Maximize admissions and overall occupancy!
- Contract with multiple insurance companies by completing one MNS contract and credentialing packet. It’s that simple!
- Maximize your admissions and overall occupancy! Our team continuously seeks out additional managed care contracts for you, both on a local, state, and national level.
- Increase revenues while decreasing administrative costs! MNS can work in place of a full-time employee to obtain managed care contracts, negotiate rates and ensure contract language is in your best interest.
- Industry experts on your side! MNS has 25+ years of experience and has worked with hundreds of payors across the county.
Credentialing
All Inclusive Credentialing Services!
MNS will oversee initial credentialing and re-credentialing needs—regardless of whether the contract is through MNS or via the skilled nursing facility.
MNS maintains comprehensive and secure credentialing files, ensuring our member facilities are in full compliance with the credentialing requirements of each applicable payor, giving your staff more time to focus on what really matters: patient care.
MNS partners with providers to help gather and maintain all the required documentation (both from the facilities and from state and federal databases) and actively monitors payor credentialing anniversaries and ever-changing requirements
MNS stores all information in a secure data repository, CredentialPointe, providing you instant access to all your facility records, accessible whenever or wherever you are!
CredentialPointe
Cutting edge credentialing solution!
Maximize Efficiency with Automation
- Streamline credentialing processes to give your staff more time to focus on higher value tasks.
- View, update, automate and store all credentialing and recredentialing documents in one place – accessible whenever or wherever you are!
- Current contract and application status available at your fingertips!
Preserve Par Status with Payors
- Avoid delays and non-compliance issues due to missing or incomplete recredentialing paperwork to ensure you have continued par status for all your current payor contracts.
- Auto-populate all credentialing and recredentialing applications including supporting documents!
- Receive dashboard alerts when documents need updated or have expired.
- House all payor agreements (even those you hold direct!) in one place – giving your staff uniform access so you never miss a placement.
Clinical Services
Our nurses are available 24 hours/day, 7 days/week, 365 days/year.
- Our expert nurses manage cases for 2,400+ patients per day, making 350,000+ calls per year on behalf of our provider partners, giving your staff back valuable time to spend on patient care and strategic marketing efforts to increase census.
- Complex cases? We can help! MNS has extensive knowledge about payor processes, requirements, and documentation needs.
- MNS will handle the paperwork and behind the scenes functions! Our team is available 24/7 to provide support for patient placements, benefit verifications, and authorizations.
- One accountable point of contact! MNS streamlines the admissions process and eliminates the confusion of dealing with dozens of individual plans.
Claims
One contact for payments and collections!
Our billing teams touch more than 1,000 unique claims per day achieving extraordinary levels of accuracy.
Accurate and timely payments! MNS will oversee billing across ALL available payors and products so your staff no longer needs to familiarize themselves with numerous different billing procedures.
MNS ensures that claims are complete, accurate, formatted, and transmitted according to each payor’s unique requirements, reducing delays and alleviating frustration for your staff.
MNS works for you! We handle appeals and respond to managed care audits, buffering you from expense, risks posed by potential offsets or recoupments.
Receive your money faster! MNS uses electronic claims submission and Electronic Funds Transfer (EFT) to expedite payment to you.
We are here to help every step of the way! After your bill is submitted, we will continue to monitor the entire collections process and proactively contact payors to ensure progress, sending reminders, and making follow-up calls on your behalf.
Education
We partner with you to ensure success!
- Maximize your admissions and overall occupancy! Build key relationships with acute care providers and referral sources to drive utilization.
- Increase census! MNS provides your local hospital discharge planners with access to our online Provider Mapping Software, which shows your current insurance contracts as well as the services you offer.
- Ongoing support and education! Whenever and wherever you need it.
- Strengthen relationships with referral sources! We help your leadership team spearhead joint marketing endeavors, continuing education events, and unique networking opportunities.
Market Analysis & Consulting Services
We recognize that many providers simply need a trusted partner to help advise them on how to best capitalize on the growing managed care population.
MNS can help…..
- Identify and obtain contracts! Become a preferred provider with the most sought after payors in your area.
- Analyze and improve! MNS will analyze your case mix and discuss opportunities for census development.
- Evaluate existing rates. MNS will review existing reimbursement of managed care rates and discuss opportunities for increases.
- Manage Credentialing! Our credentialing experts oversee your organizations’ status for current and future managed care contracts, regardless of whether the contract is provided by MNS.
- Streamline Admissions! We partner with your staff to streamline the process for concurrent review, providing standardized forms, and a thorough understanding of your facility’s payor contracts and payment structure.
- Improve Care Coordination Processes! Our experienced Clinical Services team reviews clinical information to advise on skilled coverage and the suitability of a patient’s admission to your facility.
- Benefit Checks. Let MNS assist you in checking all of your patients’ health benefits, saving your staff valuable time.
Customized Reporting & Online Services
Start to finish: We’re here for you!
Customizable reports! Monitor your referral sources, utilization data, key process metrics, trends, and turnaround times.
Real-time access! MNS’ Provider Portal offers 24/7 access to your payor contracts as well as all the current reimbursement and rates structures.
Quickly and easily generate reports specifically targeting your private insurance and managed care inpatient cases.
Access your claims at any time! Verify claims, approve for submission, or simply check the status of payment – either by individual case or across multiple facilities within your organization.
CHOW Services
One point of contact for all your managed care needs!
- Seamlessly transition existing agreements to new owners, management groups, or while aligning with hospital partners (e.g., QIPP, UPL, etc.).
- Avoid a lapse in par status! MNS will communicate changes with each plan on your behalf to ensure facility information is current and you can continue accepting referrals.
- Also included: Review of existing reimbursement and contract language to ensure you get the maximum benefit of each agreement.
- Start to finish: we’re here for you. MNS will coordinate the execution of each agreement to ensure you remain a participating provider with each health plan.
Contract Management
Everything you need in one place!
Keep all your managed care contract data in one place – accessible whenever or wherever you are! Contracts can be added in real-time, ensuring you never miss a placement with a contracted payor.
Quickly view contract details, such as reimbursement, local Medicare Advantage enrollment, effective dates, exclusions, and more! Your database can be customized to meet your specific needs.
Identify high-value contracts in your local markets!
MNS will analyze local and regional managed care markets to include: Medicare Advantage enrollment, risk group information, payor trends and coordination with your admission staff to identify contracts of need.
Secure high-priority agreements! MNS will identify facility strengths and capabilities and put our industry experience, existing relationships and current insights to work for you!
