Title: RESPONSE PAPER
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As the CFO of community memorial Hospital, I have a major responsibility to decide if I will work together with Mega plan as our preferred provider network. Commercial Intertech the largest employer in thee community has already signed a contract with Megaplan and I myself has received a proposal from Megaplan to work with us. The problem with working with Megaplan is that they require us to give their customers a big discount of 35% from charges and there is service pre-authorization before you provide treatment to their patients and they are known to fight every claim hospitals make. I must figure out if I need to work with Megaplan because there will be a major risk involved in working with Megaplan Insurance.
After considering the situation, I choose not to work with Megaplan health insurer first because it has a high discount charge. I know from experience that a hospital will lose money when ever the discount charges exceed 20%. When we lose money we do not get profit or more badly we will be left with less or no money to pay our staff. This means that working with Megaplan insurance is risky. Megaplan’s intention is to get too much money from us without considering our financial status (Berger, Steven, 2008).
Again, Megaplan requires us to consult them before treatment of a patient registered with them so that they can pre-authoritize the service. This will add more work in the office as our staff will have to confirm first from the health provider if their client will receive health care services. This will add the workload of our station and also cause delay in service delivery due to the additional tasks our staff will be taking care of. It would be beneficial if Megaplan had another way to verify their clients rather than burdening the hospital with extra duties.
Megaplan is also known to turn