Preparation is key to successfully negotiating an insurance contract with a payer, according to a LinkedIn post from Suzann Crowder, CEO of Health Care Billing of St. Charles.
Three ASC insights she shared:
1. Collect data. Have a year's worth of case costing, case mix and quality data to show the payer. It also helps to have data about what makes your ASC better than the competition, such as patient satisfaction, bundled payment programs and highly rated clinicians.
2. Consider the ASC's needs. Keep in mind what the ASC's stakeholders want out of the contract negotiation. Some factors to consider include implant reimbursements, prompt payment requirements and claims processing.
3. Carve out the necessary time. It can take multiple meetings spread out across several weeks to complete a contract negotiation. ASC staff should come prepared for those meetings with the terms the center is willing to accept.