Contract Review & Negotiation Overview
Everything You Need for Efficient Payer Contracts
GetixHealth understands that payer contract management can be a challenging and resource intensive process. To assist clients, GetixHealth can provide experienced consulting support services through the process that can assist you and provide stronger contract outcomes.
Contract Review
GetixHealth performs detailed contract review to identify potential contract opportunities and risks.
Contract Negotiation
Comprehensive contract negotiation services to expand the efficiency of your practice.
Follow-up & Support
GetixHealth takes the time to monitor necessary follow-up and support for efficient payer contracts.
GetixHealth will take the following steps to assist clients in its review of the payer contract:
- GetixHealth will undertake an initial review of administrative contract terms.
- GetixHealth will undertake an initial review of reimbursement terms and methodologies.
- GetixHealth will evaluate any financial and/or administrative counterproposals from payer.
- GetixHealth may compare the contracts proposed rates to other client contracts.
- This process usually takes a maximum of 10 hours but may be increased dependent on the complexity, length, exhibits, and products included in the contract.
GetixHealth will take the following steps to assist client in its negotiation of a payer contract:
- GetixHealth shall maintain current and ongoing contract with payer on behalf of client until client has determined negotiations.
- GetixHealth will provide recommendations and decision support to client during this project.
- GetixHealth will make recommendations and advise when client representatives should attend direct meetings with payer.
- GetixHealth will copy emails and correspondence to client.
- This process usually takes a maximum of 10-15 hours but may be increased dependent on the length of the negotiation and number of payer-client exchanges.
Comprehensive Revenue Cycle Management
Put our experience and expertise to work for you!
GetixHealth may take the following ancillary steps where requested by the client:
- Detailed fee analysis of payer impact on top procedure codes.
- Review of provider manual references and content for administrative impact on client.
- These services are billed at an hourly rate.
Clients do have specific responsibilities during contract activities:
- Providing competing payer contracts where applicable
- Providing prior payer contracts where applicable
- Providing top procedure codes and fees
- Contacting and confirming any additional conditions of confidentiality with the payer
With SVA (Healthcare) capturing potentially missed services through their certified coders, RAA’s production increased 10.59% and our collection of receipts also increased by 12.14% in 1 year.
Dr. Fred Panzer, Radiology Associates of Appleton
With SVA (Healthcare) taking a proactive approach, WRS’s denied claims have been reduced by 50%.
Al Jensen, Wisconsin Radiology Specialists
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