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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Physician looking up healthcare payer reimbursements to increase their medical practice revenue

Keep It Simple – Payer Contract Negotiations

You need to have the tools that will illuminate the added value your organization provides to their members. Remember that you are providing a valuable service to their organization and

Payer reimbursements are the foundation of your practice revenue, but unfavorable contract terms can cost you thousands of dollars.

Don’t Let Your Payer Contracts Auto Renew Yet Another Year!

Payer contracts contain language that affects your practice’s financial well-being. You will end up stuck with outdated contract terms that don’t meet your practice’s current needs. Payer reimbursements are the

Physicians run the risk of being reimbursed from an outdated payer fee schedule without a focused strategy to analyze payer contracts and reimbursements. You must put a strategic plan in place.

Making Payer Analysis A Priority

Accepting payer contracts and fee schedules as the status quo is one of the most common reasons why practices struggle to remain profitable. Physicians run the risk of being reimbursed

It is important that practices familiarize themselves with the entire HCPCS system to ensure appropriate coding and claims reporting of quality measures.

The Healthcare Common Procedure Coding System (HCPCS)

Great news, we will be adding all HCPCS Level II codes to our 2022 Contract Analyzer. Two principal subsystems, referred to as Level I and Level II of the HCPCS.

The fee schedule, sometimes referred to as the charge master, is arguably the single most important financial tool within the medical practice.

How To Set A Standard Fee Schedule For Your Practice

The fee schedule, sometimes referred to as the charge master, is arguably the single most important financial tool within the medical practice. Although your standard fees are not necessarily the

It is more than possible for practices to restructure payer contracts and achieve a higher fee schedule.

You Can Restructure Payer Contracts To Increase Revenue

For many physicians, it’s easy to get caught in the mindset that there’s nothing you can do to increase revenue from payer contracting. However, it is more than possible for