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Written by Reed Tinsley, CPA | November 1, 2011
Evaluate payer performance based on the insurance plans that account for the highest volume of revenue to the practice. Examine and compare their reimbursement rates for the top CPT codes utilized in the practice. This will identify under-performing contracts that compromise practice profits.
Other factors in evaluating payer performance include:
The level of cooperation and support the plan’s provider relations department gives;
How promptly claims are adjudicated;
The number of errors in paying claims; and
The number of denials that require the practice to fight for its money.
