PMI Learning Center

Managing Payor Rates

Written by Paul Vanchiere, MBA | Sep 26, 2024 3:04:04 AM

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: