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Payer Analytics

Advanced Analytics. Superior Reporting.

Payer Proposal Models

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A critical component of negotiations is understanding the outcome of proposals that payers will send to you during the negotiation process.  These proposals often change the configuration in how you will be paid.  Your contract may be on the 2015 local CMS adjusted reimbursement rate and your next proposal could be a % of a payer specific 2020 fee schedule.  Do you have the tools in place to properly evaluate these conversions?  We do!

A managed care negotiation strategy is not sound without in-depth analytics into the proposals exchanged between the provider group and the payer.  Payers purposefully change the reimbursement mechanism to confuse and trick providers in accepting the same or even lesser paid rates. Coupled with your billing data, we use several tools from Excel, PowerBI, Tableau and others to evaluate the proposals and report them back to you to make the best informed decision for your practice. 

Dashboards & Reporting

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Does your practice struggle to have a handle on payer mix, managed care revenue, product splits, revenue by location, etc.?  We work with your revenue cycle or finance teams to build comprehensive models and dashboards that can allow you to drive down to specific levels not seen before in small practices.

Product Splits: understanding Medicare v. Medicaid v. Commercial reimbursement 

Revenue by payer, service line, Location, Provider, CPT code, therapy, etc.

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