{"id":893,"date":"2013-10-15T10:16:49","date_gmt":"2013-10-15T10:16:49","guid":{"rendered":"http:\/\/www.medicalbillingstar.com\/blog\/?p=893"},"modified":"2017-02-14T07:09:48","modified_gmt":"2017-02-14T07:09:48","slug":"negotiating-medical-practice-payer-contracts-to-your-advantage","status":"publish","type":"post","link":"https:\/\/www.medicalbillingstar.com\/blog\/negotiating-medical-practice-payer-contracts-to-your-advantage\/","title":{"rendered":"Negotiating Medical Practice Payer Contracts to Your Advantage"},"content":{"rendered":"

\"Insurance<\/a><\/h2>\n

Rapidly Changing Medical Reimbursement Environment :<\/b><\/span><\/h2>\n

Over a period of time, considerable changes in complexity and scope of contractual negotiations and agreements with federal, state, and private insurance organizations have been experienced by clinics and hospitals. At present, most of the practices accept whatever the insurance companies offer, rather than resorting to implement insurance contracts on a win-win basis.<\/p>\n

This results in losing out on additional revenue to the tune of 15%<\/strong>. Successful renegotiation of insurance contracts results in a typical yield of 10-12 %<\/strong>. This is money that is available but lost because most of practices do not have the expertise to renegotiate their insurance contracts. The medical practice<\/a> not only suffers from a bad insurance contract, but doesn’t even know what’s in the contract.<\/p>\n

Expert Opinions :<\/b><\/span><\/h2>\n
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Brian Workinger, business solutions consultant at Craneware<\/strong>, a specialist in software for health care billing, auditing, chargemaster management and medicare compliance, emphasizes “the need to compare reimbursement rates of insurance companies, rates of nearby hospitals, and know the clinic\u2019s market shares in medical services. This information will help to negotiate with the insurance companies.”<\/p>\n

According to Kyle Kobe, principal at Equation,<\/strong> a healthcare consulting firm, “it pays to do an extensive homework and understand the existing contracts, know market contract rates, and determine how the existing contracts can be improved.”<\/p>\n

Mary Ely, director of physician relations at Greater Baltimore Medical Center (GBMC)<\/strong> and head of managed care and negotiations with insurers, adds that “there is a dire need to claim denial histories, Medicare fee schedule changes and insurance contracts, and follow up by extensive research on existing contracts. “<\/p><\/blockquote>\n

Multi-pronged Approach :<\/b><\/span><\/h2>\n

MedicalBillingStar has developed a sophisticated model that analyses existing and proposed contracts and ensures that the hospital management understands the financial and operational implications of existing contracts, as well as the implications of new contracts and\/or proposed changes. We offer effective insurance contract negotiating services to the medical practitioners<\/a>. We:<\/p>\n