Motti Edelstein, vice president of revenue cycle at Minneapolis-based Allina Health, said his background has helped him see payer relationships in a different light.
"Part of my career path included being in either the department of managed care or working on the payer side," Mr. Edelstein told the "Becker's Podcast" during the 11th Annual Healthcare CEO + CFO Roundtable in November. "Because I had that background, I don't approach this as an 'us vs. them' type of thing like many others do."
Mr. Edelstein said it's about finding relationships with the right people with the right information.
He said Allina has set up a payer relations escalation process whereby anyone within revenue cycle has the ability to add a challenge or a problem. That then turns into a monthly meeting with payer relations.
"Our payer relations/managed care department now has real examples that they can bring to the payers," he said. "They do so with people from my performance management team from revenue cycle and it works. We create relationships with payers. We don't tell when there's one claim that was not paid correctly. We don't tell them when it's a $5 copay that somebody incorrectly received … we aggregate, we raise big issues and because of that, they're willing to listen to us."
Mr. Edelstein said it doesn't work 100% of the time, "but it's a constant relationship building both between revenue cycle and payer relations internally, as well as revenue cycle and the payers themselves."