Recognizing Similarities in Payer Contracts
The purpose of this article is to share observations about how understanding both the similarity of payer contracts and the key elements in these agreements can help you to maximize your payer contracts’ reimbursements.
This is especially true with the same commercial payer, across locations. Understanding payer contracts is like learning to drive different cars. That is, there are many varieties and brands of cars but once you can drive one, you can drive almost all of them since, fundamentally, they have the same requirements, e.g., need to start, need to brake, need to steer, need to replenish fuel or, most recently, electricity, etc.
What does this mean in the context of payer contracting? First, let’s examine some key common elements of payer agreements. This is a sampling of selected parts of payer agreements, and is meant to orient you to identify key and likely common items to look for.
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