Data can provide physician practices with valuable insights during negotiations with payers, according to Kyle Kobe, vice president of consulting/analytics services for Alpharetta, Ga.-based nThrive.
Mr. Kobe shared the following tip with Becker's Hospital Review.
"Insurance companies possess vast amounts of data and sophisticated modeling tools to give them a tremendous advantage in negotiating rates. Healthcare providers often lack sufficient analytical tools or a full understanding of how a proposed contract might impact revenue — costing practices millions of dollars.
"The bottom line is data offers providers with the competitive advantage and insights to swing the negotiations in their favor. We recommend utilizing the physician practice billing and contract data as well as market intelligence to analyze the proposed payer rates and their effect on a practice's top line. When it comes to rate negotiation, payor contracts are put in context with the rest of the commercial business and Medicare, so consulting with experts familiar with your market will put you at an advantage."
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.