Many healthcare practices start off with exceedingly small budgets. They have just enough money set aside to start their business, relying on insurance credentialing companies to help them make sound decisions when it comes to provider enrollment, and to ensure they get the best reimbursement rates for their services.
Here are just a few key strategies to help you determine which payer mix might be best for your practice:
The first thing a provider can do to help ensure they are choosing the right payer mix is to survey the demographics.
- Take the time to research the demographics of the area you are beginning your practice in. Areas of focus could include competing practices, the total member population (and mix), and any ethnic backgrounds that may require special needs such as interpretation services.
The second aspect that cannot be overlooked is to ensure the appropriate provider(s) are in place for your unique specialty.
- Often times, payers will look at a provider’s credentials, certifications and awards to determine the rate at which they are able to reimbursed for services rendered. Although a provider may be accredited, many things like board-specialty certifications and medication-waivers cannot be overlooked when starting your practice to ensure you are compensated at the highest level for the services you are providing for your patients.
Finally, you must know what plans are offered in your area.
- It is critical to have a clear understanding of all plan options for your served geography. If you don’t already know which plans would best optimize your practice, your Credentialing Specialists at Bikham can help you make these important decisions by doing market research regarding which plans are offered and the percentage of the population for each plan.
