What is Payor Strategy?- (Payors) refers to healthcare coverage providers and insurance companies. Having operated several treatment programs, I know that healthcare is not a static commodity. It is not uncommon for companies to vary in reimbursement rates, fluctuate in the number of days authorized or be inconsistent in requirements. I help providers identify ways to maximize reimbursement, leverage their strengths and identify ways to adjust during times of change.
Payor Compliance- Many insurance companies have varying demands. Company (A) may audit specific levels of care but be generous with others, while Company (B) may place demands on the clinicians facilitating groups for their members. It can be extremely difficult to meet these demands, all while advocating and treating the actual patient. My number one goal is to minimize the impact payors have on the actual service, while maximizing coverage options of the client.
In-Network vs. Out-Of-Network Strategy- Many providers are weighing the options of IN and OON options. Furthermore, what is right for one provider may be different from another. I can assist with weighing these options and isolating a solution.