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Should You Utilize A Payor Contracting Service For Your Medical Practice?

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If you've recently made the decision to move from a hospital to your own private practice, you may be doing all you can to keep your overhead costs low while still enlisting high-quality employees as medical assistants and receptionists.

Providing a competitive salary and benefits can be a challenge when you're operating on a shoestring budget of varied insurance reimbursement procedures, and you may be reluctant to take on additional employees just to handle insurance and billing issues. On the other hand, failure to adequately manage your insurance reimbursements could cause cash flow problems that prevent any of your employees -- or even you -- from taking a salary.

What are your best options when it comes to managing your practice's finances? Read on to learn more about payor contracting to help determine whether this is the right arrangement for your medical practice.

What does a payor contractor do?

Each health insurance provider has slightly different reimbursement rates, schedules, and requirements. Many small practices find themselves accepting only a narrow slice of the insurance market simply due to the difficulty in memorizing and adhering to each of the various billing requirements put forth by the largest health insurance providers. While this can make life easier for your receptionist and financial staff, it can also eliminate a large swath of the market in your area, lowering your potential revenue.

One solution that has been utilized by a number of medical practices is a contract arrangement with a payor reimbursement agent. These professionals can help manage your business's arrangements with a variety of insurance providers without requiring you to pay salary and benefits. You may be able to enlist this help at a flat monthly or annual rate, or arrange a commission-only compensation plan where your payor contractor will receive a percentage of any discounts negotiated on your behalf.

Will you also need someone to handle collections?

Although a payor agent can help negotiate insurance discounts and reimbursements on your behalf, you may still find yourself dealing with the occasional patient who is unable (or unwilling) to pay the bill for services. When this happens, you may find your staff spending time sending out past-due notices or even filing a small claims lawsuit to seek repayment. You may want to seek out a payor contracting firm that can also handle collections on your behalf, or consider the option of selling past-due debts to a large collection agency for a certain percentage of the face value. Contact a company like HEALTHCENTS for more information.