How to keep track of and evaluate your payers

Keeping track of and evaluating Medicare, Medicaid, and other area payers is one of your most important jobs. Your schedules should reflect that significance by including processes and procedures that require continually evaluating and monitoring the largest portion of practice income. You can perform these appraisals daily, monthly, and annually.

Use these three tips to stay on top of your payers:

1. Judge the value of each third-party payer plan from the starting point of contract negotiations all the way through the claims appeals. Keeping abreast of new plans in your area may allow you to seek out other appropriate payers and negotiate favorable terms that may not be available once the payer is solidly established.
2. Use governmental agencies as resources regarding the history and litigations of specific contracts you may be considering or with which you are already on assignment. Being aware of local and national payer issues can help you retrieve reimbursements due to your practice.
3. Know your population and look at larger local employers to gain insight about future demographic trends.

When solicited, daily, monthly, and annual reporting can offer your practice management system a wealth of informaiton.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.