Essay about HSM 543 Week 6 You Decide

866 Words Feb 16th, 2014 4 Pages
You Decide-Back to the Drawing Board
Student Name
HSM 543
February 16, 2014

As the CFO of Community Memorial Hospital, I have a major problem on my hands that could lead the hospital in a financial bid. Bill Jacobs, the Human Resource Director of Commercial Intertech (CI) which is the largest employer in the community, has signed a contract MegaPlan Health. MegaPlan is a known insurance company that gives hospitals a very hard time especially when it comes to discounts and fighting claims the hospitals make. Since all of our employees and their families will be using MegaPlan Insurance and Community Memorial is not on their Preferred Provider Network (PPN), I need to figure out if we should work with or without
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I feel that I will have a better chance with MegaPlan signing my counterproposal than they have with us signing this existing contract due to the fact that I want to make sure that our patient get the best care and at the same time, the hospital will be able to survive and stay open for the community. To start with my counterproposal, I will just basically change a few things within the contract that they sent over. I do agree with a discount for the employees and their families but the hospital have to also make some money in order to stay open, so I will change the discount to 17.5% and this way we will meet in the middle. I will also change the pre-authorization requirements which will consist of getting approval for major surgeries and/or major treatments but everything else should be left up to the doctor’s decision. I will also have to include that they tell us what exactly they will need in order to approve a claim so we will not have any issues in the future. I feel that my proposal will meet MegaPlan in the halfway and at the same time help our employees, the community and also MegaPlan Insurance. I will explain to MegaPlan how important this community needs this hospital and how much we need them and Community Memorial is always thinking

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