The Healthcare reimbursement model is changing with time. More facilities are becoming in-network providers with insurance companies in their local area. Sometimes reimbursement rate offered by these in-network providers is low. However, in-network providers can get their claims processed very quickly. This will simply mean that you will get faster payments.
You will also see fewer claim denials. Also, you might see an increase in patients as more insurance companies will refer to your hospital. This can help you in attracting more patients.
Value-based care payment models will also help you in a better reimbursement rate. These models won’t offer you fee-for-service payments. However, it will offer you better reimbursement for quality outcomes. The main goal of this model is to ensure that your patients are getting the right care. In-network providers that are providing great care to their patients will have higher reimbursement.
However, it is not easy to go in-network. If your payor contract is poorly negotiated, then you will get less reimbursement rates. You need to spend a lot of time and energy in finding a good deal. There is also a great chance of errors. You can make multiple errors in this process. The best way to avoid these errors is by working with industry experts. These industry experts will help you in negotiating your contracts. They will help you in maximizing your revenue.
Why You Should Outsource Your Payor Contracting?
If you want to enjoy all the benefits of going in-network, then you should consider working with experts. The right company will help you in handling your payor contracts. They will help you in finding the best reimbursement rate. Also, they will help you in negotiating your reimbursement. Some of the main benefits of outsourcing payor contracting are:
1. Negotiate Faster
You need to spend a lot of time and energy when you are negotiating with insurance providers. Similarly, if you are trying to become an in-network provider then you need to follow a long process. Also, you need expertise in this area. Most hospitals don’t have access to this expertise.
Every insurance company will have different processes. They will follow different regulations. Thus, it is very difficult to negotiate with them. You need to spend a lot of time checking everything. If you miss any step during this process, then it will slow down the entire process. Due to this, your contract will be delayed by weeks or even months.
HPA payor contracting professionals already understand the entire payor contract process. They have worked with hundreds of insurers. Thus, they know the entire workflow process. They will help you in creating your application and ensuring that it is complete. This will ensure that you will get your contract as quickly as possible.
2. Aligned Interests
Both your practice and HPA payor contracting professionals have the same goal: to increase your revenue. They will help you in making more money by getting the best reimbursement rates. If you are not working with an expert, then you will probably end up with low reimbursement rates.
HPA payor contracting experts like HPA have good relationships with insurance companies. They will help you in getting the best reimbursement rate possible. Also, they will help you in streamlining your credentialing. This will ensure that your process will move quickly.
3. Make money by saving money
Your payor contract will have the process of filing claims. If any checkpoint is missing, then your claims will be denied. Due to this, you can lose a lot of revenue. You will spend a lot of time following up with these claims.
Read More Related: Custom Packaging Boxes
If you are working with an expert payor contract negotiator, then they will help you in creating a claim process that will work for your hospital. This will help you in avoiding denied claims. They will also help your staff in understanding the claim process. Thus, you can increase your revenue by working with payor contract negotiators.
These are the main benefits of outsourcing your medical payor contracting needs. A proven workflow process will help you enjoy the benefits of going in-network. Thus, you should consider working with an experienced payor contract negotiator.