Strong Payer Relationships Can Increase Reimbursements

Read time: 2 minutes

If you want to invest in your healthcare practice, start by investing in your payer relationships.

If you’re like most providers today, you’re hyper-focused on issues like data overload, clinical outcomes, and shrinking margins—so why should you spend time trying to “build a relationship” with your payers? The simple answer: to optimize your contracts and increase reimbursements.

 

Payers invest a lot of time and money in state-of-the-art actuarial algorithms to set fee schedules for providers. Unfortunately, providers don’t always have the resources to counterbalance payer investment. This can leave you with a limited view of how proposed contracts may end up affecting reimbursement—and you can unknowingly sign away net revenue.

 

By measuring contract-over-contract performance down to the procedural level, you can gain insights that will help you forecast a contract’s potential revenue. By timing this review before the contract starts, you have a chance to negotiate more favorable terms.

 

Can I really renegotiate a payer contract, you ask? Absolutely! After all, your payers are your customers. Not only can a fee schedule be negotiated, many other terms such as timely filing window, appeal window, and payment velocity can also be reviewed. You can initiate these negotiations through your payer provider representative—and doing so is easier if you have an existing relationship.

 

So, if a provider can increase their net revenue while also improving contract terms, why would anyone not manage the payer relationship?

 

Unfortunately, other factors get in the way like payer rep turnover, lack of structure and transparency, and an overwhelming number of contracted payers. With a contract management system, you can easily organize your contracts, aggregate data, and track communications—all so you can increase productivity and profitability, while decreasing time spent tracking down contracts and contacts.

 

To learn how Rivet can help you organize your contracts to make managing your payer relationships easier, request a demo today.