The managed care and reimbursement analysis focuses on payor reimbursement in the following areas: contract compliance, payor volume and revenue generation, payor reimbursement as compared to Medicare, payor under payment, and payor renegotiation.
The outcomes from this analysis are more favorable payor contracts, stronger payor relationships with payors that generate significant practice revenue and improved profitability.
Listed below are some of the PBC Managed Care and Reimbursement Analysis for your review:
- Payor mix analysis
- CPT driver analysis
- Managed Care Contract management including Medicare
- Payor EOB analysis
- Coding analysis and training for physicians and staff
- Underpayment review – The practice's payments can be monitored for underpayments on an ongoing basis or an annual review.