Kevin Dowdy is director of managed care for Meridian Surgical Partners.
Q: When is the right time for our ASC to drop a payor and what should we do for our patients and physicians before ending the relationship?
Kevin Dowdy: There are two key factors when determining the appropriate time to drop a payor. The first and obvious is when the current reimbursement rates aren't contributing to the financial objectives for the facility. This doesn't have to be when the reimbursement is less than the cost of providing the service. The second factor to determining the appropriate time to drop a payor is when negotiations haven't netted the preferred outcome. Remember that just because you negotiate, it doesn't mean you have to sign.
Once the facility has come to the decision to drop a payor, the most important step is to notify both the physicians and the physicians' schedulers. The physicians must have buy-in, but the scheduler can determine the success of the facility's out-of-network strategy.
Learn more about Meridian Surgical Partners.
Read more insight from Kevin Dowdy and Meridian Surgical Partners:
- 3 Successful Managed Care Contract Negotiation Tactics (and One to Avoid)
- Improve Your Struggling ASC This Week
- 3 Steps to Identify and Reduce Collections Problems
Q: When is the right time for our ASC to drop a payor and what should we do for our patients and physicians before ending the relationship?
Kevin Dowdy: There are two key factors when determining the appropriate time to drop a payor. The first and obvious is when the current reimbursement rates aren't contributing to the financial objectives for the facility. This doesn't have to be when the reimbursement is less than the cost of providing the service. The second factor to determining the appropriate time to drop a payor is when negotiations haven't netted the preferred outcome. Remember that just because you negotiate, it doesn't mean you have to sign.
Once the facility has come to the decision to drop a payor, the most important step is to notify both the physicians and the physicians' schedulers. The physicians must have buy-in, but the scheduler can determine the success of the facility's out-of-network strategy.
Learn more about Meridian Surgical Partners.
Read more insight from Kevin Dowdy and Meridian Surgical Partners:
- 3 Successful Managed Care Contract Negotiation Tactics (and One to Avoid)
- Improve Your Struggling ASC This Week
- 3 Steps to Identify and Reduce Collections Problems