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People news: Leadership changes at VGM


WATERLOO, Iowa – VGM & Associates has announced that Scott Owen will transition from vice president of sales to vice president of contracting. In his new role, Owen, who has been with VGM for three years, will have oversight of the vendor contract division.

Legal landscape: M&A, managed care top hot spots


YARMOUTH, Maine – With increased complexity in the HME industry, comes increased legal ground to cover, say healthcare attorneys, particularly in the areas of mergers and acquisitions, and managed care.

Home infusion providers make gains


MedTrakRx, a pharmacy benefit manager, has selected ARJ Infusion Services, a specialty pharmacy, to provide home infusion therapies to patients with complex, rare and chronic conditions.

Contracting: Set your chargemaster

Q. How can I not get bitten in my payer agreements?

A. One of the most common and often misunderstood potential hazards in payer contracts is the “lesser of billed charges” language found in almost all contracts.

Contracting: Beware these contract pitfalls

Q. What are some red flags in payer contracts?

A. In addition to contracted rates, there are key items often found in payer contracts that can significantly affect and often reduce reimbursements. Here are a few to look for:

Contracting: Offer best value proposition

Q. How can I get contracted into closed and narrow networks?

A. It is often challenging for HME companies to get contracted with payers. Payers often close their networks to new provider applications once they reach a certain number of HME companies. 

Home Care Medical snags HMO contract


NEW BERLIN, Wis. – Home Care Medical has reached an agreement with Trilogy Health Plan to be an in-network provider for its new Medicaid HMO health insurance members in southeastern Wisconsin.

Contracting: Evaluate, then rate

Q. What are areas of importance for rating vendors?

A. Vendors play an essential role in a provider’s success at contracting. Any great business has performance standards and guidelines for their vendors. If you are only looking for low pricing, keep in mind that sometimes the lowest price comes with the lowest service.

Contracting: Find another way in

Q. How do I get access to private insurance contracts when the network is closed?