At Commonwealth Billing, we offer more than just credentialing. We provide contract negotiation and renegotiation services to new and existing clients.
One thing is clear: the operating costs associated with private practice are increasing at an exponential rate. The problem is that reimbursement rates are going up, and now down. But is that really the case?
We have negotiated or renegotiated payer contracts on behalf of our clients
and increased payer reimbursement as much as 150%. We can sit down with you and help you learn the in-and-out's of your practice and help you create a SWOT analysis (strengths, weaknesses, opportunities and threats).
This introspection should be based on hard data, such as the number of new
consults and cost of drugs utilized by physician. This data should be maintained
and tracked on a monthly, quarterly, and annual basis to determine trends. This
information will also be crucial when determining what reimbursement rates you
want to target when renegotiating, and what rates you need for survivability.
Similarly, you should obtain a list of your most commonly utilized CPT codes and have your billing department, or RCM company, provide you with a list of reimbursement for each CPT code by payer. Once you have this information you will be able to determine which CPT codes provide the best reimbursement and which payers provide the best reimbursement by CPT code. This analysis should also look at your types of payers.
Interested in getting some more money in your pocket? Contact us.