NFMGMA January 2013 Educational Session – Negotiating Your Payer Contracts

Penny Noyes – Health Business Navigators

by Richard Stokes

Now that 2013 is here and we’ve had a week or two to dust of the holiday haze it’s time to get back to business.  Our first speaker for 2013 is Ms. Penny Noyes – CEO and founder of Health Business Navigators.  Penny has been working in the healthcare industry for more than 30 years and started Health Business Navigators 14 years ago.  Her mission, back then and still today, is to help medical practices to quickly, easily and affordably steer through the field of medical payer contracts.

This subject is extremely relevant to practices today because the vast majority of their revenue is based on the agreement that they have with the Payer and the networks.  On top of that, Payers are regularly exercising their rights to change the rules and policies as it relates to payments, adjustments and reimbursements.

What’s even more concerning is that with Obamacare, Payers are going to be that much more likely to exercise these provisions and with more frequency.

Some of the topics she is going to cover with us are:

    • How to inventory current contracts and rates
    • How to evaluate those that need attention
    • How to model and negotiate new rates
    • How to identify when the practice can renegotiate
    • How to identify and manage the contract provisions that protect the practice

Penny says that staying ahead of these changes, rather than a step behind, should lead to an improved or – the very least – an equal revenue model.

After her presentation, some of the actions she hopes you implement in your own practice would be:

    • Gather up and evaluate all payer agreements and rates
    • Determine which need attention
    • Create a strategy to address them
    • Search for a few key reimbursements and administrative provisions in the agreements that need management

Ask any stock broker and they’ll tell you that ‘money makes the world go round.’  So if you want to manage your money better in your practice you need to sign up for this month’s meeting.  Penny is, of course, going to be a great resource for you so please ask questions both during the meeting and after.

If you like to do your own homework and want some other reference points, Penny suggests you look in to:

    • CMS site for Medicare rates (as a baseline)
    • State laws that relate to key contract provisions
    • Your local, state and national MGMA’s

If you haven’t already registered for this month’s event, what are you waiting for?  Feel free to share this with your peers and colleagues and invite them to attend as well.  North Fulton MGMA.

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Richard Stokes: As the Director of Sales for Network 1, Richard identifies “future” clients that can benefit from the support of an experienced, outsourced IT team. He helps clients and prospects find technology solutions they need to achieve better productivity and efficiency so they can focus on making money and growing their businesses.

Network 1 designs, builds and supports the IT you need to run your business more securely, productively and successfully. Whether you want to outsource all of your IT needs to a reliable, responsive, service-oriented company, or need to supplement the work of your internal IT staff, we will carefully evaluate where you are now, discuss where you want to go and implement and support a plan to get you there with as little interruption as possible.

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