Grading major insurance payers on key metrics can help inform future contract negotiations and boost an ASC's overall profitability, according to Regent RCM.
Regent RCM Senior Director Erin Petrie said ASCs can start with four metrics:
1. What the insurer pays for a procedure
2. How fast the insurer pays
3. The percentage of claims the payer denies
4. Which reimbursement methodology the payer uses
Ms. Petrie said developing and maintaining a payer-tracking process is worth the effort. ASCs can use the data to identify wrongful denials, payment timetables and negotiation strategies.
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