Health Plan Administration, Operations and Cost

Containment Services

The Law Offices of Sheila Deselich Cohen  offers contract drafting, review and negotiation services in connection with a variety of health care service and product agreements, including:

The Law Offices of 
Sheila Deselich Cohen

Experience

There are numerous service providers within the health care industry that deliver their particular solutions either directly to plan sponsors and insurance carriers, or indirectly to other service providers acting as intermediaries on behalf of plan sponsors and insurance carriers. The service agreement between the contracting parties is instrumental in defining the role of each party, the scope of services to be provided, and any limitations on the obligations of each party. For the past 20 years, Sheila has worked with third party administrators, business process outsourcing companies, provider networks (including travel networks), telemedicine companies, health care technology companies, brokers, business developers and health care strategists to determine the terms and conditions of the delivery of their products and services within the self-funded, fully-insured and Taft-Hartley (multi-employer) plan markets. Sheila has been fortunate to have been engaged by and collaborated with some of the largest insurance companies and health plan servicing entities in the country.

Having reviewed and authored hundreds, if not thousands, of agreements on behalf of a variety of vendors within the health care industry, Sheila is able to provide contracting services without "reinventing the wheel" or encountering a learning curve. While every transaction is unique, and there is generally not a one-size-fits-all model or template to cover a particular transaction, there do tend to be themes and similarities running throughout such agreements. Sheila's experience enables her to identify quickly not only the issues that need to be included and addressed within a particular agreement, but also the types of provisions that may be unfavorable to a particular service provider.

740.917.5155

  • Third Party Administrative Services Agreements

  • Network Access Agreements

  • Participating Provider Agreements

  • Re-pricing and Bill Negotiation Agreements

  • Independent Review Organization (IRO) Service Agreements

  • Pharmacy Benefit Management Agreements

  • Broker/Commission Agreements

  • HIPAA-compliant Business Associate Agreements

  • HIX Technology Platform Agreements