Imagine the ability to see into your financial future.
To gather payer contract proposal data, analyze it and model a new fee schedule before you enter negotiations. It’s possible and easy to see into the future with the right solution, which gives physicians an advantage in payer contract negotiations.
By using the payer’s newly proposed contracting information, physicians can model their expected future payments. This helps physicians understand where they may gain or lose as part of the new contract.
Having this information in advance of the contracting process helps providers understand their new payment schedule and provides negotiating power. With the right contract management solution in place, it’s possible to see into the future and influence it today. Contract negotiations are one part of an overarching contract management solution to ensure a fair and equitable payment negotiation.
As part of revenue cycle management, contract management is key to the ongoing prosperity of your practice.
4 Tips for Successful Contract Management
The work actually begins before you ever see the payer contract. A contract management solution should allow you to model payer contract proposals before negotiations. This helps you see into the future, and to understand how the practice fared in the past with existing agreements. This process ensures the practice contracts for the best possible terms.
It’s the first step to ensuring you and your practice are paid correctly for the services you provide.
Four tips to help physicians receive the correct payment for services:
1. Model the payer’s new contract offer to gain insight into payment changes. Analyze and use the information in negotiations.
2. Use an automated program to monitor payment accuracy by importing your negotiated pricing into a database that compares actual payments with the contracted amount. This also provides the ability to analyze contracts over time to learn which payers have more frequent payment issues.
3. Knowing you’ve been underpaid is important, but doing something about it is vital to your practice. Real-time automated appeals enable your practice to submit appeals easily and quickly. Because the appeal is submitted electronically, you’re also informed as soon as it’s received by the payer.
4. A prospective or retrospective audit of billing practices confirms claims are coded correctly. Either way, it’s better for you to discover any errors or ongoing coding discrepancies before being approached by the payer. This offers the opportunity to correct any problems and confirm you haven’t been overpaid. Analyzing this data helps to ensure the practice passes any payer audits.
Physicians who use these four tips give themselves an advantage in all phases of contract management. From the day a payer’s proposed fee schedule is received to the day payment is collected, an integrated contract management solution can help ensure cash flow and prepare the organization for the future changes in reimbursement through the utilization of current and past data.
Allen Latham is Vice President of Revenue Cycle Management at TriZetto Provider Solutions, a Cognizant Company.