As a single practice, payor negotiation can be challenging. While many offer standard contracts with favorable reimbursement rates compared to being out of network, that often means practices leave money on the metaphorical table. However, getting to more favorable terms is an investment, and a practice may not be able to staff in-house. Choosing our payor negotiation service means access to our professional network and specialized team, which helps practices tackle these complex negotiations. Since we work with payors every day, we have a network of relationships to leverage to help our clients.
Generally speaking, all payors want to improve their financial outlooks while maintaining compliance with the relevant legal standards. This strategy ensures that they can continue to operate. However, when approaching negotiations, it’s vital that practices keep the payor’s priorities in mind. Otherwise, the payor is unlikely to be swayed into a more favorable contract. For many practices, patient experience sits higher on the priorities list than some of the general payer priorities do. Choosing our experienced team can bridge the divide and help a practice negotiate a more favorable contract that lets them serve more patients.
Sometimes, payer strategy and payer negotiation services highlight a necessary change for a medical practice. These types of changes may require an extensive investment to change how a practice does things, but they usually result in a smoother experience for everyone. These changes might improve patient experiences, overall RCM trends, staffing security, and more. However, actual implementation can be a challenge, especially if it’s to a well-established routine in the practice. We can help streamline changes as well as overall operations for practices looking to improve their efficiency. We can even help implement unique arrangements with our specialized AI and technology team. Once changes are in place, the practice can enter into more cooperative relationships with a variety of entities and adjust to further changes with less inconvenience. These shifts often complement other changes practices make, such as changing to an IDR service or applying AI solutions to RCM for more consistent results.
No Surprise Bill (NSB) has unique relationships with payors. Since we work with them daily to resolve claims, NSB can help our clients develop unique arrangements with payors that provide beneficial financial rewards.
Our payer negotiation services are a unique opportunity to help your practice negotiate favorable terms, address claims directly, and set your practice up for future cooperative relationships with a variety of entities.