Payer Contracting: Have You Reviewed?

A payer contract might be harming your practice. The content and verbiage of the contract itself should be able to protect you from amendments that the payer can suddenly implement. There are many ways this could harm you and unfortunately many physicians frequently overlook this important component. There are many changes in the contract that can constitute the breaking of a deal. So you have to be aware of what your practice might be getting into with a payer contract.

Is your collections rate about 95% or more? You should be receiving at least that amount for the medical billing at your office. Many practices bleed money because there is not a proper understanding of payer contracts. To bill accurately you need to understand who you are working with.

Medcare MSO offers:
A fee schedule
A ruled payment
Measurable criteria
Submission time frames
The Payer Contract Dissected

As a physician you understand that many insurance companies often standardize the contacted rate based on the area in which you are providing services. The language of the contract should of course reflect this. But, it should also be able to portect you with changes that might happen when the payer decides to suddenly shift gears.
What You Need To Walk Away From:

Changes in the number of permissible visits and the service dates
The procedure reduction and changes

When the payer is not working with you correctly that should be a red flag. Medcare MSO’s medical billing service begins with the contract not the first submission, so ensure that you have evaluated these contracts completely before you have signed off on them.

Contact Medcare MSO today to get your free demo!

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