Craig M. Arnold, Managed Care Actuary

Services for Medical Groups

 Capitation and reimbursement analysis: Exactly what are you being paid, and how does that compare against your other agreements?  How are the assumptions used by the insurance company different from your business?  Can those differences be used to your advantage?  What did the insurance company forget?

 Contract negotiation assistance: What contract details can be changed in your favor (even 'non-negotiable' items)?  What items will the insurance company usually give up to you if you ask?  Simply having a knowledgeable actuary on your side of the table gives you an edge.

 General data analysis and data mining: You have a problem, but where?  Are the reports you are using really what you think?  Your reports can be automated to be both faster and more useful.

 Reserving: Are your financials accurate?  Many provider organizations seriously underestimate the amount of reserves required to properly assess their operations and financial strength.

 Reinsurance: Do you need stop-loss?  At what level?  If you have it, are your arrangement(s) the most advantageous for you?  I can help you develop a clear strategy for coverage.

 

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