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Negotiating Payer Contracts for Physicians

August 22, 2011

The importance of negotiating or renegotiating payer contracts has drastically grown after the recent health care reforms. This is because insurance companies are being reined in by the government and may see a decline in profits. This presents a good opportunity for payer contracts to become a source of income more for the insurance companies rather than for physicians. Therefore it has now become even more important for physicians to negotiate and renegotiate payer contracts and read the fine print. Moreover, it is apparent that you as a physician would gain experience as the contract progresses and would need increments in your reimbursements.

Many physicians do not bother to review and renegotiate their contracts and insurance companies also do the same since it is in their interests to do so. Private insurance companies usually have a tenure within which physicians must renegotiate their contracts or the contract is automatically renewed at the old rates. Furthermore, the technicalities and the complexity of payer contracts necessitates time and effort which many physicians cannot afford to dedicate due to a busy schedule. This is where the administrative role of medical billers and coders who are professionals in this area can be of immense importance.

Calculating the exact revenue or earnings that you receive from every patient visit and distributing them among the major plans such as Medicare or Medicaid can give you an idea of the qualitative time spent on such plans and patients. This way you can decide which insurance contracts need renegotiation. There are numerous other aspects such as meetings with insurance representatives, correspondence, and legalities involved in payer contracts that make it a job for professionals. Medical billers and coders who have experience in this area can not only renegotiate contracts which are better paying but also provide you with value added services such as credentialing with various payers among others.Analyzing and calculating reimbursement rates annually or periodically is also a crucial aspect of payer contracts.

With so many insurance providers, it becomes difficult as a physician to keep track of all the changes happening in the health care sector. Our medical billers and coders at medicalbillersandcoders.com have been in this business for so long that they are armed with up-to-date information about various payers and changes in the health industry. This can help you in increasing your revenue by as much as 10% and also relieve you of the effort taken for negotiating or renegotiating payer contracts. We also provide other value added services such as background assistance and credentialing for new practices and for business expansion.

Moreover, since negotiation of payer contracts is a long and periodic process it would make sense to hire professionals who are experienced in this area instead of putting in your own valuable time and effort.
For more information on negotiating and renegotiation of payer contracts, please visit medicalbillersandcoders.com


Category : Revenue Cycle Management