Case Analysis



Case Analysis

Preparation

Negotiation is referred to as the most common approach utilized to manage dispute and make decisions. Mainly, when a medical group, a doctor, a hospital or any medical provider consents to be contracted or agrees in participating with a contract of health insurance, they concur to provide medical assistance and care to the patients who have health coverage or medical services covered at a cost that is normally less than what a provider usually charges for the similar services.

In order to effectively undergo contract negotiation, one requires a considerable experience and exposure, education to uphold the negotiation and most of all a complete period of training. Fully prepared negotiators seem to possess a strong hold on their field related information which permits them to critically assess the case and turn it around in support for their party. In this essay numerous aspects of renegotiating a contract with Yellow Patriot Insurance Company have been explored which incorporate the knowledge and skills required to make sure that the re-negotiating a 3 year contract goes successful.

As contract negotiations turn out more productive if prior preparation is done. Therefore, preparation should be started by targeting Yellow Patriot Health Insurance Company (payer), profiling them and collecting information about the company which was required in order to handle the negotiation in a better way.

Furthermore, analytical skills are also an important aspect while preparing for a contract negotiation. These skills refer to ones capability of critically analyzing the scenario and problem at hand, and then propose solutions and alternatives which present the most effective solution. It is imperative for contract negotiators to have good analytical skills because this ability allows them to consider a scenario from various aspects and thus provides them a rather holistic picture of the entire case. This goes on to help them reach a credible solution.

In re-negotiating with Yellow Patriot Health Indsurance Co. mainly there will be two parties involved in the contract negotiations, one will be our negotiating team and the other will be the vendors' or payer's team, apart from this individuals or groups who have a stake in the outcome can also be involved with the negotiations. The negotiating team will highlight the past performance of the company in order to re-negotiate and extend the contract for a periods of three more years. Every contract team want to obtain the best possible pricing and service therefore, out team wil calibrate current pricing with industry market pricing for the same services provided. Another thing which our organization experienced was delayed payment of claims, Yellow Patriot Co. needs to reimburse for the payment delayed after a specified time period. The deciding factors might include:

Fee Schedule

Pricing Issues

Service Management

Problem Identification

Problems must be negotiable. In order to negotiate successfully, the negotiating team must consider that there are suitable agreement choices that are possible as an outcome participation in the procedure.

The problem in this case is to re-negotiate for a 3 year contract with Yellow Patriot Insurance ...