Managing Payor Rates

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This presentation from PMI's Lunch & Learn Series to help pediatric practices learn what they need to know to manage their payor rates.

 

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Additional  Resources:
Spreadsheets:

Simple tracking sheet to assist practices in monitoring overall financial activity and collection ratios by payor.

 

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Useful spreadsheet to monitor payment rates for the most frequently used CPT codes in pediatric practices, categorized by payor. 

 

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Spreadsheet to assist pediatric practices in comparing the actual payments received from MCOs to determine which payor(s) are paying less than others.

 

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Spreadsheet to assist practices in comparing the total anticipated revenue based on CPT volume by payor.

 

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Spreadsheet designed to assist pediatric practices in evaluating the financial implications of proposed fee schedule adjustments.

 

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Spreadsheet designed to help pediatric practices keep a detailed and comprehensive comparison, by payor, of key terms in MCO contracts.

 

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NJAAP Pediatric Practice Management Presentation

The Most Common Issues Pediatric Practices Should Address presented by Paulie Vanchiere

Spend A Day Coding With A Pediatrician presented by Richard Lander

Where Is Your Practice Losing Money presented by Chip Hart

MCO Negotiation Presentation At PCC UC:

Getting Your Data Ducks In A Row presented by Chip Hart

Finally At The Table: Managing Contract Negotiations presented by Susanne Morgana-Brennan (Formerly Madden)

Understanding Business Implications: Navigating Possible Outcomes presented by Paulie Vanchiere

Practice Manager's Perspective presented by Kimberly Brennan:

 

Picture of Paul Vanchiere, MBA

Paul Vanchiere, MBA

For over 15 years, Paul has dedicated himself exclusively to addressing the financial management, strategic planning, and succession planning needs of pediatric practices. His background includes working for a physician-owned health network and participating in physician practice acquisitions for Texas's largest not-for-profit hospital network, giving him a distinctive insight into the healthcare sector. Paul is adept at conducting comprehensive financial analysis, physician compensation issues, and managed care contract negotiations. He established the Pediatric Management Institute to offer a wide range of services tailored to pediatric practices of all sizes and stages of development, with a focus on financial and operational challenges. Additionally, Paul is actively involved in advocacy efforts to ensure healthcare access and educational opportunities for children with special needs.

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