The physician-patient relationship receives a fair amount of attention, particularly with Meaningful Use Stage 2 and its patient engagement requirements fast approaching.
However, payer-provider relations can be just as important to your practice’s viability. Forming fruitful relationships with the companies that reimburse your claims can be the difference between getting paid or not.
So today, we’ll reveal four methods for improving the relationship between your payers and your practice.
Establish Clear, Transparent Contract Rules
Payer contracts are at the heart of payer-provider relations. They are the rules around which the relationship develops.
Before signing on the dotted line, make sure the contract terms are well defined, transparent and agreed upon by both parties. This reduces the possibility of future disputes, as either party can simply point to the contract when disagreements arise.
Also, keep an eye out for “evergreen” clauses. Payers sometimes sneak these in so contracts automatically renew upon expiration unless the practice notifies the payer otherwise. Don’t get locked into contract terms that will end up causing grief later.
Reduce the Administrative Burden
Practice management software does more than save your practice money. It lessens the administrative burden for both you and the payers you work with. Features like contract rules checking and code scrubbing help you submit clean claims, which keep you from irritating payers by constantly submitting incorrect claims.
Many payers also make provider portals available so practices can check on the status of their claims and perform other essentials online. The fewer unnecessary phone calls you make to a payer, the more likely they’ll be responsive when you actually need them.
Courteous Phone Demeanor
Speaking of phone calls, your staff should always conduct payer phone calls in the friendliest manner possible, no matter how frustrating the situation. Remember, even with the largest payers, there’s still a person on the other end of the line.
Often times, your practice will end up dealing with the same individuals when calling state-based payers. If these people have a good rapport with your practice, they’re more likely to help you when needed. But if they have a reason to dislike your practice, they’ll probably do the bare minimum when it comes to providing assistance.
Outsource
Outsourcing your medical billing doesn’t improve payer-provider relations per se, but rather eliminates relations altogether – which can be a good thing.
Instead of having to put effort into the relationship, the task is left in the hands of your billing agency. If there are any conflicts, the agency handles these instead of the issue tying up your staff’s valuable time. To top it off, outsourced medical billing has been shown as a more cost-effective option than keeping billing in-house.
Unless you are running a concierge-style practice, you likely depend on payer reimbursements to keep your practice running. With this in mind, it’s vital to cultivate a strong payer-provider relationship to ensure your practice has every possible financial advantage.
