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Just say no to poorly performing payor contracts
1Healthcents, Inc., Corral de Tierra, CA 93908, USA. charkin@healthcents.com
The Journal of Medical Practice Management : MPM
|January 17, 2009
Summary
Physicians can increase their revenue by annually reviewing and negotiating with healthcare payor contracts. Proactive contract management can significantly improve physician reimbursement rates despite rising overhead costs.
Area of Science:
- Healthcare Management
- Medical Economics
- Physician Revenue Optimization
Background:
- Increasing practice overhead costs and decreasing healthcare reimbursements are eroding physician net revenue.
- Physicians often perceive limited control over their service reimbursements.
- This financial pressure necessitates strategies for improving practice profitability.
Purpose of the Study:
- To outline a process for physicians to impact their reimbursement rates.
- To provide actionable suggestions for productive and lucrative payor negotiations.
- To empower physicians in managing their financial well-being.
Main Methods:
- Annual review of existing payor contracts.
- Strategic negotiation with healthcare payors.
- Leveraging contract terms from a position of strength.
Main Results:
- Physicians can influence reimbursement levels through contract negotiation.
- Proactive engagement can lead to more favorable payment terms.
- Improved negotiation strategies result in enhanced revenue.
Conclusions:
- Physicians can actively improve their financial standing by managing payor contracts.
- Annual contract review and negotiation are crucial for maximizing reimbursement.
- Strategic financial management is key to physician practice sustainability.
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