Navicure News

 

TIPS, TRICKS & TACTICS
CONTRACT NEGOTIATIONS: NAVICURE HELPS OPTIMIZE FEE SCHEDULES WITH PAYMENT ANALYSIS REPORT

Navicure is renowned for helping physician practices boost revenue through claims management – minimizing rejections, reducing days in A/R, enhancing cash flow.

Now we are adding yet another valuable tool: support for effective - and successful - contract negotiations.

Of course, getting claims paid is critical to a healthy bottom line. But making sure they are being paid fairly and appropriately is just as important to practices. That’s why Navicure developed its Payment Analysis Report. Advanced functionality extracts remittance data on a payer-by-payer basis (see sample, below), or provider, facility, procedure and denial code basis. Practices can review the amounts submitted for payment – and what they actually received in reimbursement. In addition, they can examine contracted rates and reductions, allowed amounts, co-insurance and deductibles, and denials. With this level of detail and the ability to compare performance among payers, practice representatives can approach contract negotiations armed with irrefutable data justifying an increase in the fee schedule.

The Navicure Payment Analysis Report is being made available at a time when favorable rates are more important than ever. Costs are going up, and minimal annual adjustments do not begin to cover increases in labor, malpractice and supply expenses. Negotiating even a small increase for a few codes can have a significant impact on the bottom line. In an article available through the American Academy of Family Physicians website (AAFP), author Gregory J. Mertz, MBA, FACMPE, notes that “solid data and a well-reasoned approach are key to negotiating better reimbursement rates.”

Navicure clients will have these tools at their fingertips in early June. Please monitor your Navicure Message Center for the product announcement and webinar invitations.

A MEDICAL PRACTICE
Processed Date: 02/02/2008-03/03/2008

Payment Analysis By Payer

Payer
Name
Submitted
Paid Contract & Oth Reduct
Contract & Oth Reduct
Allowed
Co-Ins &  Deduct
Denied
Aetna
$1,533,990
$309,836
$1,155,895
$809,408
$94,819
$69,543
Blue Shield
$2,914,108
$675,920
$2,099,803
$1,464,731
$227,499
$197,949
Humana Enterprises Inc
$69,412
$15,947
-$98
$69,412
$6,258
$0
Medicaid
$514,587
$42,734
$471,853
$108,734
$0
$49,119
Medicare - Railroad
$65,842
$11,933
$50,926
$14,916
$3,288
$5,439
Medicare
$4,197,408
$807,815
$3,158,811
$1,193,511
$294,122
$335,802
Pacificare
$834,982
$232,171
$620,608
$228,746
$14,940
$0
Unicare Special Accts
$138,823
$17,422
$100,654
$38,169
$28,036
$7,375
United Healthcare
$1,520,701
$435,385
$970,262
$597,616
$123,555
$73,316
TOTALS
$11,789,853
$2,549,163
$8,628,714
$4,525,244
$792,517
$738,543

>>BACK TO MAIN PAGE

 

spacer   spacer