12 Oct Getting Paid Appropriately by Your Insurance Providers
Are you looking to make a positive change in the way your practice deals with payers? You have the power to make this happen....
Are you looking to make a positive change in the way your practice deals with payers? You have the power to make this happen....
If a pediatric practice has some extra down time, pause and remember the financial health of your practice starts with having an appropriate fee schedule. While contractually the payers determine how much they are going to pay you for each service you provide, it starts with how much you charge. Scheduled Processes and Procedures At a minimum, at the beginning of the year, your practice should have a scheduled process and procedure for updating your fee schedule so you can be sure you are not leaving money on the table (and in the insurance company’s pocket.) The AAP has resources for pediatricians...
When reviewing (or developing) your revenue cycle management plan, don't overlook the first steps: making sure all your providers are appropriately credentialed with all your payers and associated products. Credentialing and Provider Enrollment are more than just arduous tasks of paperwork; without them, claims aren’t paid and revenue suffers. Opportunities to grow your practice and strengthen your revenue depend on a solid credentialing and contracting game plan. Key functions that help your practice receive proper reimbursement from insurers: Payer Product Analysis: Most insurers offer multiple products and these products can change annually, especially Medicare Advantage, Medicaid HMO, and ACA plans. Review your...
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