MARK R. DALTON

MARK R. DALTON

VP of Manage care, IPA/MSO, contracting

Mark comes to ProMed Management group from Eye Specialists of Arizona/ Vision Twenty-One/ Supervision, where he managed $80 million and 350,000 lives in Ophthalmology, Optometry, and Optical network for Southwest Region, Maryland, Pennsylvania, New Jersey, New York, and Florida. Mark’s responsibilities consisted of managing and controlling all aspects of accounting and cash flow management for multiple capitation contracts. Negotiations of capitation agreements with National Insurance companies, physicians groups, and individual providers. Mark reviewed all financial information for the four networks in multiple states. Presented on ESA capitation model to potential new Ophthalmology clients and for a nationally known consulting group. Marketing of Vision Twenty-One and their networks to insurance companies nationwide. Reviewed utilization of all Ophthalmology networks nationwide to determine if networks were meeting specified goals. Chairman of Vision Twenty-One’s national utilization committee.

Mark has a long history of MSO consultation.  Mark owned Professional Business Partners INC. where he consulted with MSO’s, MCO’s, insurance companies, physicians groups, and individual physicians assisting them in financial planning, negotiation of capitation contracts, utilization management, medical practice patterns, network management, and computer modeling. Mark negotiated capitation contracts for physicians and physicians groups. Created utilization benchmarks for reviewing agreements to determine if the contract will met the established goals. Mark also created computer capitation program utilizing standardized software programs to streamline capitation model, which reduced claims processing from 31 days to 10 days for Ophthalmology network which eliminated 40% of claims processing staff for Ophthalmology client. Mark created claims lag studies to determine the appropriate level of claims accruals and assisted practices in cash management forecasts and budgeting.