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.
Webinars and Training
National Center for Innovation in HIV CareMay 2016
Case study showing how an organization transitioned from an HIV/AIDS housing organization to an agency with growing revenues in the healthcare field.
Training resources on enhancing billing systems to maximize revenues, covering CPT and ICD codes in the HIV/AIDS care context.
CRE TA CenterApril 2016
Tips for negotiating contracts with insurers.
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).
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
CRE TA CenterMay 2017
Tips to help Ryan White HIV/AIDS Program providers to take concrete steps to improve their contracting and billing processes.
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.
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.
CRE TA CenterSeptember 2015
Tool for assessing organization regarding areas of importance to insurers and that support maximizing revenue from contracting activities.
CRE TA CenterMarch 2015
This Roadmap can help you navigate resources that deal with contracting, billing and enrollment with Medicaid and Marketplace Insurance Plans.
Reports and Best Practices
Sustainable Strategies for RWHAP CBOsMay 2018
This needs assessment was conducted by Primary Care Development Corporation (PCDC) as part of the Sustainable Strategies for Ryan White HIV/AIDS Program (RWHAP) Community Organizations technical assistance project.