Hold payers accountable to contract terms to ensure there is no money left on the table.
Kassandra Kurth, Director of Strategic Initiatives, Experian Health: Hold your payer partners accountable to the contractual terms with your healthcare organization using contract management and analysis tools. These tools can help you accurately identify appeals and recover underpayments that can be used as a matrix measurement for overall contract performance. In addition, working with seasoned contract analysts within your vendor's organization can provide you with the reassurance that your contracts are maintained and valued to their highest reimbursement levels per the intent of your contractual terms. Contract analysis tools can help increase your leverage at the negotiation table with payers by modeling contract proposals against your specific claims history data. They can also provide your organization with information about the financial impact of payer contract proposals and assist in forecasting managed care contracts revenue.
If you would like to share your RCM best practices, please email Carrie Pallardy at cpallardy@beckershealthcare.com to be featured in the "RCM tip of the day" series.