7 Guidelines for Better Payor Contracts

Caryl A. Serbin, RN, BSN, LHRM, president and founder of Serbin Surgery Center Billing, suggests following these seven guidelines to improve your payor contracts.

1. Ensure your contract rates cover case cost plus profit margin
2. Be sure that contract pays for multiple procedures
3. Ensure that implant rates cover cost plus shipping and handling
4. Be aware that Medicare implant reimbursement does not always cover cost
5. To ensure you are being paid accurately, load and maintain up-to-date contracts in your software. Include:

• Rates by CPT
• Discount on multiple procedures
• Implant allowance

6. Provide personnel with current insurance matrix
7. Maintain implant fee matrix

Learn more about Serbin Surgery Center Billing.

Read more insight from Caryl Serbin:

- 6 Areas of Focus for Collecting Full Payment: Critical Steps to Take Prior to Billing (Part 1)

- 5 Steps to Finding the Right ASC Reimbursement Cycle Employees

- Guidelines to Assign ASC Reimbursement Cycle Responsibilities to Staff Members

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