Contracting
Collection of resources on contracting with health insurance plans and provider networks, with an emphasis on leveraging the agency's role as an Essential Community Provider (ECP). Marketplace plans must include some ECPs in their provider networks.
Resources 11
Webinars and Training
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Primary Care Development Corporation (PCDC)July 2019
This webinar focused on the strategic considerations and practical implications of collaborating as and ASO/CBO in the delivery of HIV services.
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Primary Care Development Corporation (PCDC)July 2019
Learning module series for Ryan White-funded Community Based Organizations (CBOs) and AIDS Services Organization (ASOs) staff involved in billing who are:
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HealthHIVMay 2016
Training resources on enhancing billing systems to maximize revenues, covering CPT and ICD codes in the HIV/AIDS care context.
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CRE TA CenterApril 2016
Tips for negotiating contracts with insurers.
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CRE TA Center, National Center for Innovation in HIV CareNovember 2015
Review of the basics of Medicaid contracting with a focus on Medicaid Managed Care Organizations (MCOs).
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CRE TA CenterOctober 2015
Review of contracting opportunities (e.g., marketing when negotiating contracts) for Ryan White funded agencies that provide medical care and other services.
Tools and Job Aids
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CRE TA CenterMay 2017
Tips to help Ryan White HIV/AIDS Program providers to take concrete steps to improve their contracting and billing processes.
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CRE TA CenterMarch 2016
Tool for conducting a cost analysis: the process of determining the unit cost or the average cost of providing specific services over a defined period of time in order to use this information to bill and secure reimbursement for services provided.
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CRE TA CenterJanuary 2016
Actions agencies can undertake to expand or establish contracts with Medicaid or Marketplace Insurance Plans. Tailored for Ryan White HIV/AIDS Program (RWHAP)-funded core medical provider managers or administrators.
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CRE TA CenterSeptember 2015
Tool for assessing organization regarding areas of importance to insurers and that support maximizing revenue from contracting activities.
Reports and Best Practices
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Primary Care Development Corporation (PCDC)May 2018
Results of needs assessment to guide the development of training and technical assistance services to help ASOs and CBOs increase their capacity to provide direct HIV care and treatment.