Surgerynet is governed by its Executive Committee subject to the principles as set forth by the Board of Directors. Surgerynet has contracted with Medical Network Management, Inc. (“MNM”) to provide the network with professional management services and related administrative infrastructure. MNM is an affiliate of Medical Management Associates, Inc., a well-known Atlanta-based physician practice consulting firm. MNM’s services include:
Governance support including scheduling and staffing meetings of Board, Executive Committee and other committees, preparation and maintenance of company records, and assistance with organizational, legal, and regulatory issues and management of financial resources.
Strategic planning, marketing, contract negotiation and on-going liaison with contracting plans.
Network development including physician and practice recruitment, credentials review and contracting.
Financial management including but not limited to financial reports and management of IBNR reserves.
Provider relations services including assistance in securing plan credentialing, physician and practice staff orientation, facilitating communication and effective problem resolution between the plan and providers.
Development of clinical criteria and guidelines.
Utilization management services including surgical pre-authorizations, prospective, concurrent and retrospective reviews.
Quality improvement studies.
Development and management of other network–sponsored programs and services.
MNM is certified as a Private Review Agency by the State of Georgia and is accredited by the American Accreditation Healthcare Commission/URAC.
Surgerynet also contracts with LifeWell Health Plans, a licensed Third Party Administrator, for claims processing and payment services.
