Proposal for billing changes for Medicare, Medicaid, and Managed Care, and explain how the proposed changes will benefit the organization, the physicians, and the patients.

Regardless of the corporate structure, health care organizations must remain financially viable. Income must be forecasted according to existing contracts with stakeholders, such as insurers and private payers and state and federal payers.

What changes you would like to make to the billing policies and procedures in a successful physicians clinic. Include the following in your proposal:

• Develop a step-by-step process for the entire revenue cycle from pre-verification of insurance to accounts receivable management.
• Recommend a method for determining a pricing structure. What factors can influence pricing?
• Explain the factors that must be considered while negotiating insurance contracts. What major payer categories are appropriate for this practice?
• Explain how the clinic will handle private pay and charity care.
• Recommend either an installed or a web-based billing software system. (Please note that you should not recommend a specific brand of software; just the type of software.)
• Explain how the changes will benefit the physicians, the clinic, and patients.