There are five Managed Care Organizations (MCOs) who have won bids to participate as part of North Carolina Medicaid Managed Care. You will potentially be contracting with all of them. In an effort to minimize your administrative burden and assist in this process SembraCare would like to offer you the option to join the Messenger Network we’ve established, Sembra Messenger Network (SMN).
SMN will benefit you in several ways.
SMN will pay for a professional legal review of the non-financial and non-competitively sensitive terms of the basic provider agreements which may be tendered by various MCO payers. If needed, feedback to the MCOs on the general terms will be developed by the lawyers and SMN.
SMN will facilitate your contracting of the financial terms with each MCO by conducting a Provider Fee Survey, for each provider type. The overall, non-provider specific results from the fee survey will be conveyed to the MCOs so as to advise them how many of the providers they can contract with at certain price points. Your fee survey data is not to be shared by you with other providers and must be kept entirely confidential. SMN will also not share your fee survey data with any other provider.
SMN will expedite the transmission back and forth of the MCO offers and your responses and reaching an agreed result. This streamlined method alleviates the burden of communicating individually with the five MCOs. You alone will have the option to determine whether the fees or terms are acceptable, what fees or terms you would agree to, and whether or not you want to move forward.
Managing contract paperwork will be greatly simplified. SMN will maintain required confidentiality throughout the process, and will also provide easy to use document management tools, like DocuSign, that can be used to sign online with the click of a button.