Given the upheaval caused by Covid-19, it’s an interesting time in most industries, and healthcare is no different. If you, like many other practices, are experiencing a little less patient volume, now might be a great time to focus on strategies that will yield positive returns when things pick up. One of these strategic moves might be to invest time in payer contracts.
Let’s start with a scenario: Imagine you are on the job hunt and receive a call from a potential employer letting you know that you got the job. You are excited by this news and ask about your salary. The employer replies that you should wait for your first paycheck to find out. You then ask what hours you should expect to work. Your employer responds that they will let you know if you miss your shift. Lastly, you ask where you should submit your timecard. The employer says that they will deny your paycheck for timely submission if it’s late.
While we know this scenario sounds crazy and you would never treat your employees this way, it still begs the question -- Why would you allow this sort of relationship with your insurance payers? In most practices, payers make up 70-80% of the revenue, but most providers do not know what is in their contracts. Knowing your contracts can empower you to collect even more and protect your practice.
The main reason you may not have a copy of your contract with a payer or know what they contain is because collecting them can be hard. And while it is your contract, with your signature, it can still take a significant amount of time (weeks or months) to obtain after requesting them. Plus, once requested, it can take a diligent follow-up effort (phone call, emails, fax request, payer portals, mail, or direct rep outreach) from you and your team to finally secure the contract.
Now that we know how difficult it can be to obtain payer contracts, running a good process for compiling them is key. The following are a few tried and true tips to help you meet your goals:
Collecting and compiling payer contracts might feel like a daunting undertaking at first, but now is the time to take it on. You have a right to your contracts, and understanding what they contain will lead to more empowered decision making and added value to your practice.