Payer Contracts and Fee Schedules Blog
We discuss common issues that healthcare professionals encounter in their payer contracts and suggest ways you can improve your contract and fee schedule issues.
While working with healthcare groups across the country, we have seen payers reduce their fee schedules by 5% to 12% due to lack of attention, this is devastating to your practice.
The purpose of the CodeToolz Payer Contracts and Fee Schedules blog is to provide physicians with information to help them make sense of the growing complexity of payer contracts and gain leverage when negotiating with payers. We believe in a proactive approach, not a reactive one.
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Payer Pricing Set To Go Public
In today’s digital age, people are empowered with access to knowledge like never before. With one exception – most Americans still have no idea what their healthcare visit will cost
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BREAKING (9/2/22): NEW CPT® CODES FOR BIVALENT COVID-19 BOOSTERS
The AMA recently announced an editorial update to CPT®, that includes eight new codes for the bivalent COVID-19 vaccine booster doses from Moderna and Pfizer-BioNTech. The updated boosters are adapted
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Understanding Value-Based Healthcare
The shift from a fee-for-service healthcare delivery model to a value-based care model, has significantly changed the way healthcare is delivered and reimbursed in the United States. What Is Value-Based
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Identifying Top Payers And Negotiating Wisely
Payer contracts are a vital part of the healthcare system. They impact everything from reimbursement rates to provider credentialing. With the right information, organizations can negotiate great payer contracts and
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The Value Of Independent Practices Cannot Be Disputed
The independent practice is becoming an endangered species. The corporatization of medicine is depleting competition in the healthcare marketplace, leading to higher prices for patients and lower pay for physicians.
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Understanding Payer Mix
Payer mix is a function of the number of patients you have for each payer and how much each payer reimburses at the CPT® code level. The first step to