Payor Benefits
Partnering with USPASS offers significant advantages for Managed Care Organizations (MCOs) and other payors. Our comprehensive approach streamlines processes, improves quality management, and enhances care coordination across our provider network.
Key Benefits
Lower Administrative Costs: Streamlined processes reduce overhead.
By partnering with USPASS, MCOs significantly reduce the administrative burden associated with managing a network of individual skilled nursing facilities. Instead of engaging in separate negotiations, credentialing processes, and ongoing communication with numerous providers, USPASS acts as a single point of contact.
- Reduced Staff Time: MCO staff spend less time on individual contract negotiations, credentialing paperwork, and resolving issues with multiple facilities.
- Lower Operational Expenses: Less paperwork, fewer individual contracts to manage, and a centralized communication channel translate to lower printing, mailing, and communication costs.
- Increased Efficiency: Streamlined processes free up MCO staff to focus on other strategic initiatives, such as member care management and quality improvement programs.
- Simplified Reporting: USPASS can provide aggregated data and reports across its network, simplifying performance monitoring and analysis for the MCO.
Simplified Contracting: Single agreement for multiple facilities.
USPASS offers MCOs the convenience of a single master agreement that covers access to its entire network of participating skilled nursing facilities. This significantly simplifies the contracting process compared to negotiating and managing individual contracts with each facility.
- Reduced Legal and Contractual Complexity: A single agreement is easier to review, understand, and manage than numerous individual contracts, reducing legal and administrative complexities.
- Faster Contracting Cycle: Negotiating one agreement is significantly quicker than engaging in multiple rounds of negotiations with individual facilities, allowing for faster network access.
- Consistent Terms and Conditions: A standardized agreement ensures consistent terms, conditions, and payment structures across the network, simplifying administration and reducing the risk of discrepancies.
- Scalability and Flexibility: As the USPASS network evolves, the MCO can often gain access to new facilities through amendments to the existing agreement, rather than initiating entirely new contracts.
Efficient Credentialing: Centralized process for network providers.
USPASS manages the credentialing process for all its network facilities, ensuring that they meet established quality and regulatory standards. This centralized approach offers several advantages for MCOs:
- Reduced Credentialing Burden: MCOs are relieved of the time-consuming and resource-intensive task of individually credentialing each participating facility.
- Ensured Compliance: USPASS ensures that all network facilities meet the necessary licensing, certification, and quality standards required by regulatory bodies and the MCO.
- Consistent Credentialing Standards: A centralized process ensures consistent application of credentialing criteria across the network, promoting a uniform level of quality.
- Up-to-Date Information: USPASS maintains current credentialing information for its network providers, reducing the risk of outdated or inaccurate data.
Support for Site Visits and Chart Reviews: Facilitates quality oversight.
USPASS actively supports MCOs in their quality oversight efforts by facilitating site visits and chart reviews within its network facilities. This assistance can include:
- Coordination and Scheduling: USPASS can help coordinate and schedule site visits and chart reviews with the relevant facilities, saving the MCO administrative time and effort.
- Point of Contact: USPASS can act as a central point of contact for communication and logistical arrangements related to site visits and chart reviews.
- Understanding of Network Standards: USPASS's familiarity with its network facilities and their quality standards can help MCOs focus their review efforts effectively.
- Potential for Collaborative Quality Initiatives: USPASS may facilitate collaborative quality improvement initiatives across its network, aligning with MCO goals.
Claims Liaison Services: Assists with claim-related issues.
USPASS acts as a liaison between the MCO and its network facilities to help resolve claim-related issues. This service can significantly streamline the claims process and reduce administrative friction by:
- Troubleshooting Claims Issues: USPASS can investigate and help identify the root causes of claim denials, delays, or discrepancies.
- Facilitating Communication: USPASS can act as a central point of contact for communication between the MCO and the facility regarding specific claims.
- Advocating for Resolution: Leveraging its relationships with payors, USPASS can advocate for fair and timely resolution of legitimate claims.
- Improving Payment Accuracy: By helping to resolve claim issues, USPASS contributes to more accurate and efficient payment processes.
Premier Referral Network: Provides a high-quality network for their members.
By partnering with USPASS, MCOs gain access to a curated network of skilled nursing facilities that have met USPASS's quality standards. This "premier referral network" offers several advantages for the MCO and its members:
- Access to Quality Providers: The MCO can confidently refer its members to facilities known for their commitment to quality care.
- Diverse Service Offerings: The USPASS network encompasses a wide range of post-acute care services, ensuring members have access to the specific care they need.
- Geographic Coverage: With facilities across New Jersey, Pennsylvania, and Delaware, the network provides convenient access for members in these regions.
- Member Satisfaction: By providing access to a high-quality and diverse network, the MCO can enhance member satisfaction and improve health outcomes.
To learn more about how USPASS can benefit your organization, please contact us for a personalized consultation.
Phone:
973-686-3233 877-465-7277
Fax: 973-686-3668
Quick Links
One Network...
...One Solution
© 2026 US Post Acute Service Solutions - All Rights Reserved