Payer contract negotiations can be tricky, and the utilization data held by providers and payers can vary significantly and have a big effect on negotiations and outcomes. How do you effectively resolve this issue? Healthcents’ CEO and Co-Owner, Steve Selbst, has put together valuable information that will help you understand why you need to trust your own data during contract negotiations.
This article is titled “Trust your own data.” What does this mean and why is this a revelation? Let me begin by saying that this potential landmine came to light in several recent and complex payer contract negotiations that I personally led. It involved a large specialty practice and large health insurance companies. The issue is that the utilization that the payer had in its system varied significantly from the utilization in the provider’s system. By way of illustration, suppose we have two codes, 99213 and G6016, a radiation oncology code….
To read the full article, please fill out the brief form below.