In order to maintain a healthy revenue stream, it is key that your practice has a well-balanced mix of payers. If your revenue stream seems to be sagging it could be that your payer mix has shifted in a negative direction. That is, you may have seen patients with coverage from lower, poor, or slow payers. Here are some things you can do to address that situation.
First, break down your patient list into the payers by whom they are covered. You will likely find that the most common groups of payers are government agencies such as CMS (Medicare and Medicaid); commercial carriers like Aetna, Blue Cross Blue Shield, CIGNA, Humana and others; Worker’s Compensation, legal claims, and self pay. You should also identify, and be paying attention to, plans obtained through the Health Insurance Exchange marketplace created by the PPACA.
Each of these payer groups have particular policies and procedures associated with payment rates, promptness of payments and coverage of services.
Once you’ve identified your payer mix and the areas in which it could use improvement, there are steps you can take to create a favorable shift in your payer mix.
Taking the time to identify your payer mix and taking the steps which will shift that mix in a more favorable direction will yield results. None of these methods are high-cost, and yet all of them applied in tandem can contribute to a much healthier bottom line for your practice.
ourtesy via Stuart Miles/freedigitialphotos.net