Why You Should Outsource Payor Contracting

As healthcare reimbursement models change, more and more facilities are choosing to become in-network providers with major insurance companies in their area. Though reimbursement rates may be lower, in-network providers get their claims processed faster, which means faster payment. They also see fewer claim denials and may even see an increase in patients due to referrals from insurance companies.

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Value-based care payment models also offer higher reimbursement for in-network providers. These models, instead of offering fee-for-service payments, offer higher reimbursement for quality outcomes. The goal of these models is to incentivize the right care that leads to healthier patients. In-network providers who have great patient outcomes can expect higher reimbursements that fee-for-service out-of-network providers.

Though there are clear benefits of going in-network, you may not see them if your payor contract is poorly negotiated with poor reimbursement rates or the wrong services covered by insurance. You can avoid these errors by outsourcing payor contracting to industry experts who understand how to negotiate contracts and maximize your revenue.

Top Reasons to Outsource Payor Contracting

The right payor contract helps you see the full benefits of going in-network. The right company to handle your payor contract helps you see these benefits from the very beginning—even before you turn in your application.

Save Time and Negotiate Faster

The process of becoming an in-network provider is long and detailed. To further complicate matters, each insurance company uses a slightly different process and slightly different regulations to credential your practice. These applications can become extremely time consuming, consisting of seemingly endless paperwork. And if you miss a step in your application, it can slow down the entire process, delaying your contract for weeks or months.

Medical billing experts, like the team at DataPro, understand how the payor contract process works with each insurer. They have a proven workflow process to create your application, ensure it is complete, and keep the process moving forward.

Fewer Denied Claims

Your payor contract will carefully outline the process for filing claims. If the agreed upon process in your contract does not match your current practices, you may see all your claims denied. Not only will you miss out on revenue, but you’ll spend hours and hours of time following up on these denied claims.

An experienced payor contract negotiator understands how to create a claims process that works for your practice or facility so you can avoid denied claims. They can also help your staff understand the claims process, reducing the number of errors made and increasing your revenue.

Higher Reimbursement Rates

The initial contract may include reimbursement rates that are too low for your services. Negotiating these rates takes a lot of time, energy, and experience.

Datapro has longstanding relationships with insurance companies and years of experience with the payor contracting process. Thanks to this experience, we understand what a good reimbursement rate is and can help you negotiate for higher rates.

When you work with Datapro’s contracting services, you can expect higher negotiated rates and many more benefits, like streamlined credentialing that keeps your application moving quickly. We’ll also keep you updated on the process so you won't spend time worrying.

Our expert team has negotiated hundreds of high-paying contracts for our clients and developed a proven work-flow process that helps you see the full benefits of going in-network. Contact us today to learn how we can help you throughout the payor contracting process.