1. Rollover contracts from your joint-venture partner when possible.
2. Know your case costs before starting negotiations.
3. Discuss multiple procedure discounts.
4. Question your carrier’s prompt-pay and timely-filing requirements.
5. Do not accept boiler-plate contracts.
6. Concentrate on carving out high-cost cases or changing the CPT to a higher paid grouper.
7. Negotiate implant reimbursement. Ensure you receive:
- a low threshold for each implant;
- at least cost plus shipping and handling; and
- no limitation on number of implants.
8. Discuss coverage of ancillary procedures, including:
- fluoroscopy;
- x-rays; and
- drugs and biologicals.
9. Do your homework (case costing) as some device-intensive spinal procedures require costly implants ranging from $3,000-$8,000 such as CPT 63655 (laminectomy with placement of neurostimulator electrodes) and 63685 (insertion spinal neurostimulator pulse generator)
10. Other spine procedures to consider when negotiating include:
- anterior cervical discectomy/fusion;
- laminectomies;
- discectomies; and
- laminotomies.
Learn more about Serbin Surgery Center Billing.
– 5 Quick Guidelines for Effective Insurance Verification
– 8 Best Practices for Contracting With the Right Insurance Plans
