It Is Important To Understand All The Details Of Payor Contracts
To be able to negotiate your existing health agreement plan, you must be able to understand all the key details in the payor agreement. Though it may not seem very important to do right now, if you do manage to spend time learning about it then this effort will pay off in the long run. You will be able to renegotiate the terms of your agreement in a much better manner. Once you know the basics, below are the steps that will guide you to negotiate and track with payors.
Start With Research
This is the first step which includes understanding and studying the current contracts and fees schedules. If you have doubts then review the terms with a payor contracting Services so that you will know the term and termination language used properly. Prepare your own proposal then and determine what options you would like to give the payor. It is very important to know who your contact is at the payor’s network so you can correspond with the right person.
Submit Your Proposal
Once you have researched everything you need to know then the next step is to prepare and submit your proposal letter. Make sure to make it impactful and try to get the payor’s attention to the value of your practice to their network. Bring their focus on tangible financial values like the revenue for the past year, the number of patients treated, geographical location, and so on. The payor must be able to see your practice from your point of view.
Follow It Up
Once you have submitted your proposal to the payor, it will take around 3 to 4 weeks for them to evaluate it. However, during this period make sure that you follow it up every week with the payor contact you have. Check properly to see if your proposal is progressing. The payor might come back with a counteroffer so be ready with your reply.
Payor’s Counter Offer
Sometimes your proposal is easily accepted by the payor and at other times this will not be the case. The times that it is not accepted, the payor will come with a counteroffer. You will need to benchmark your data to see if the counteroffer is acceptable to you or not. If you do not agree to their offer then you can go back with another offer from your side and point or specifically what you do not agree to in the original proposal.
Review And Sign
Once all the negotiations are completed and you are satisfied, then an agreement is reached. The payor will send you the contract that needs to be signed. Make sure to double-check the reimbursement rates and terms that were agreed on. The termination clause of the contract should be clearly stated. You can even ask the payors for some time to review the contract. Once you have reviewed it, you can make copies of the same and sign it. Hence that will conclude the contract process for the payor.
The basic idea here is to be able to renegotiate the terms in a way that they fit your needs. You need to research what you want and need and make sure that your message is clear to the payor.