When you are having a vision of how to proceed with your payer negotiation, you can fulfill the demand of getting money whatever may be your practice. Coders are also having a part to play in setting your negotiation process smooth.
Is contract negotiation all about asking? If you think so, please find out more about these topic now, because you are going to face a lot of loss. Not all can succeed in bargaining aren’t you aware of that? Same as that not all can find a way to renegotiate. But to get the maximum of your cash collection, you must have the ability to convince your payers. When you think to do so without hesitation collect points and convince them with the same.
Follow more about this topic by reading through this article blog:
Demand for a rise in your pay
In most cases, medical care centers or practices get their sum only via planned insurance contract negotiation, this accounts for the maximum cost in their total revenue collection. But if you think it’s enough, you won’t ever receive more for the services unless you ask for it. Simply having a re-negotiation should not only be your priority, rather trying to get success should be your preference.
Just a reminder, you can’t ask for higher payments from government payers, like Medicare or Medicaid. This makes it clear your only focus is on private insurance payers. Try to get reimbursements at the best level from them. When you find your fees are getting reduced when your payers get integrated into other insurance companies, you can question the same to them as sound as a whale.
Reveal your payer mix
For practice, it’s extremely important to identify who gives you the most and who is your best payer. For instance, if there is a group of four payers who predominantly contribute to your payment shares. Then find out the percentage among them. That is if one insurance company gives you a 10 percent share and all other three shares 80% of the revenue then your full payer negotiation skill must be on the three others.
Sit down as a group with your employees do work on it now, to revamp your payer’s contribution and obtain the fullest benefits.
Determine the current state of your reimbursement rate
One common mistake that might hold back your contract negotiation process is starting off without knowing where your reimbursement rates stand right now. In some cases, your reimbursement rate might be lesser than the fixed Medicaid pays. This can be a good reason to ask for a rate increase.
Payers usually determine the fee schedule under Medicare relative value scale. Find if the payer gets you updated with the fees.do verify which factor the payer uses to determine the fees.
Categorize the codes you code very frequently
Codes can serve as a directory for you, to find the most frequently used to most consequently used services. Here are some list of neglected codes and strategies that gives you a greater advantage.
- HCPCS level II codes will give you a fair advantage and can contribute to your monthly expense.
- Develop a billing system that can give you a report of the most used codes and frequently added codes in your system that gives a better vision of which provides more payment to your service. With this technology in hand, you don’t have to waste your time on evaluation and the percentage of success to your insurance contract negotiation will be high.
- Do verify if the charges are equivalent to the current contract’s allowed amount. Very often charges that are below the current amount are not covered.
- Find out the commonly used codes for specialty cases. Some providers will accept a rate change or increase in them, but some won’t. Collecting this information will define the mix of patients.
Final thoughts
It’s always acceptable that the provider’s core job is to provide patient care at its best. But this doesn’t stop you away from receiving the payments for your treatment service. Keeping this in mind you must collectively work on your contract negotiation criteria very frequently, working constantly to review the contracts to maintain them that of the market situations is vital.
Wondering how to stay up front and get finished this task, contact Practolytics to know more about the insurance contract negotiation services we provide for your better reimbursements.
