MMHS will evaluate and negotiate payment methods that deliver the best value in terms of net revenue and cash flow.
1. Payers are heavily invested in claims editing systems; therefore, it is often more productive to negotiate rates and methodology rather than attempting to change coding edits. As discussed in Tactical planning, coding and other administrative cost are usually best quantified into the rate discussion.
2. As illustrated on Athenahealth’s payer performance web site, www.athenapayerview.com, variance in net payment performance is significant. Auto-adjudication is of premium value in structuring compensation design that best works for your practice.
3. Package pricing services increase payment rate flexibility.
4. Leveraging data from Electronic Health Records (EHR) translates the administrative burden of Pay for Performance (P4P) programs into significant value in managed care contract negotiations.