Why Do You Need To Evaluate Your Insurance Contracts?

You’ll have a better chance of improving your practice when your contractual rates are up-to-date. Read more to find out how we can assist you in getting the correct contractual rates from insurance companies!

Dear Providers,

All participating providers should be aware of their contracted fee schedule with health insurance payers and ensure that their contracted rate is up-to-date. As credentialing experts, we often see that participating providers are unaware of their contractual rates as well as other essential contractual obligations.

We strongly advise properly maintain participating agreements with your respective insurances.

Our experience shows that established providers often get paid by old rates or an incorrect fee set up by insurance plan. That should be fixed as early as possible, as improper payments affect your practice revenue and influence your practice’s development.

•      Define your major payers

(you can use iSmart Billing Monitor dashboard)

•      Pull up or request a copy of your participation agreements

•      Evaluate the agreements

As a participating provider, you have a right to have a copy of a contract. Also, participating providers have a right to request contract renegotiations with their insurance companies. By reviewing your

practice contracts and renegotiating frequently-billed codes with your insurance companies, you will be able to improve your practice along the way.

You should not miss this opportunity!

Clearly, providers are so focused on patient care and the administration that changing an insurance agreement seems like an added headache. However, practices may be leaving many thousands of dollars on the table.

Our credentialing team can assist with contract review and negotiations. Please feel free to contact our Director of Operations, Olga, with your questions at olgak@wchsb.com or call 888-924-3973 x 1201.

We are always here to assist with your credentialing needs.