A toolkit to help physicians, preferred provider networks and payers develop a common understanding during contracting discussions has been released by the American Association of Preferred Provider Organizations (AAPPO) and the American Medical Association.
“With more than 69 percent of Americans enrolled in PPOs, our industry needs to do all we can to ensure that all parties understand the contracting process for preferred provider networks,” said Karen Greenrose, president and CEO of AAPPO. “AAPPO believes that continued collaboration with AMA will enhance communication among our members and providers.”
The Provider Contracting Toolkit is designed to create a common ground for discussions between physicians, PPNs and payers by fostering a better understanding of contractual agreements and diminish the potential for problems or misunderstandings that arise after the contract is executed.
“No physician should sign a health plan agreement without a thorough understanding of the implications for their practice,” said AMA Board Member Cecil B. Wilson, MD. “The new toolkit will help physicians get straight answers and useful information up front during the contract negotiation process, which can help establish a fairer and more balanced business relationship over the course of the contract.”
Physicians are often solicited to participate in PPNs, and clarity and transparency in contract agreements are the foundation for a fair, long-term business relationship, according to both organizations.
The toolkit provides quick reference documents on several issues that arise during the contracting process, including responsibilities of PPNs and payers, physicians contracting with PPNs, assessing network value, primary/secondary network matrix and understanding silent PPOs.