4 Bad Payer Behaviors Impacting Reimbursement for Physician Groups
Payers are making it harder for physician groups to get paid. Learn the tactics impacting revenue and how providers can resist.
Combating the increasingly complicated reimbursement landscape
Breaking Down Barriers to Payment
Payers in healthcare continue to create new roadblocks for facility-based physician groups to receive fair reimbursement. From complicating enrollment processes to excessive claim denials and contract non-compliance, each strategy delays payments and increases administrative burdens, all at the expense of patient care.
Complicating the Provider Enrollment Process
Constantly shifting rules and intentionally unclear requirements create unnecessary delays.
Excessive Denials
Unnecessary documentation requests, prepayment audits, and irregular billing and coding policies cause friction between clinical staff and insurance reimbursement.
Contract Non-Compliance
Even when favorable contracts are negotiated, payers often fail to honor agreed-upon reimbursement rates.
Abusing Patient Protections
Laws meant to protect patients can be misused by payers to deny or reduce provider payments.
Jamie Shoemaker, MD, FACEP
Emergency Medicine Strategic Advisor, Ventra Health
Read The Full Article on Becker’s Hospital Review
Payers are finding new ways to delay, reduce, or deny reimbursement for facility-based physician groups, offloading financial strain on providers and increasing administrative strain. With more time spent jumping through hoops, it’s getting harder for clinicians to focus on patient care.
Ventra Health’s leadership team outlines four increasingly prevalent behaviors from payers in healthcare and shares proven strategies to help physician groups evaluate their options. Learn how data-driven revenue cycle management, proactive contract monitoring, and industry advocacy can help providers protect their financial health and secure fair payment.
Download the 4 Bad Payer Behaviors infographic for a deeper understanding
Why Are Physician Groups Struggling To Get Paid?
Payers are making it harder for facility-based physician groups to get reimbursed fairly for their care. Denials are climbing, payments are slowing, and policy changes are adding to administrative headaches. Download our infographic to visualize the four most damaging payer behaviors and gain a deeper understanding of how these actions are affecting physician reimbursement.
Turn Insurance Reimbursement Challenges Into Actionable Insights With vSight™
Staying ahead requires real-time visibility into claim denials, contract compliance, and enrollment status. With vSight, Ventra Health’s advanced data and analytics platform, physician groups gain:
With vSight, Ventra Health’s advanced data and analytics platform, physician groups gain:
- 24/7 monitoring to detect and prevent revenue loss.
- Automated enrollment tracking to eliminate payer-related credentialing delays.
- Contract compliance verification to ensure negotiated rates are honored.
- Customizable reporting that makes accurate data-driven decisions possible.
David Reck
Chief Technology & Data Officer
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