Get the most out of your negotiations!
The best of negotiators are successful because they’ve done their homework and they bring hard evidence to their discussions. Sure, there’s a certain art to negotiations, but it’s practically impossible to argue against cold hard facts. When you go into contract negotiations with third party payers to secure the right rates for your organization, are you armed with the right ammo? Make sure that, in addition to being well versed in the right techniques and having a firm understanding of what you can give up and what you must fight for, you have the right data to back you up.
Prepare your contract negotiations arsenal by analyzing the organization’s denial data. Here are some questions to ask yourself, and some data points that will prove useful when you encounter sticking points:
- What percentage of claims does that third-party payer deny?
- How many of those denials are then overturned through appeal efforts?
- How much staff time and expense do those appeal efforts take?
- Are there particular services that are denied time and time again?
Other useful tidbits include:
- How long after claim submission does it take to receive payment/remit?
- How easy is it for staff to check the status of claims via phone or web portal?
- What is the payer mix in the region?
- Have any new large businesses opened nearby that might influence a flux in payer mix?
- How much business have enrollees in those plans contributed to the organization’s bottom line?
- What other health plans are in your organization’s market?
- What are your top services utilized by that payer’s enrollees?
It’s great to bring your poker face to the negotiating table, but it’s more effective to be able to share real world data when you can. HBI’s Denials Intelligence Solution and Revenue Optimization Analysis, in conjunction with DRG’s Employer Vantage and Managed Market Surveyor will give you insights that you can turn into action on the negotiating table, and cash for your organization.
Contact me at firstname.lastname@example.org to learn more about the insights we provide our clients.