Is your organization confident that each payor is reimbursing each procedure correctly?
Underpayments cost physician groups and hospitals millions of dollars each year; don’t allow your organization to needlessly lose revenue. Ensuring payors adhere and abide to agreed upon terms is paramount to realizing expected revenue.
Due North Analytics takes a three step approach to maximize fee schedule payments; development, impact, and analysis. Our offerings can be tailored to provide your organization with the specific service or services required.
First, Due North Analytics delves into each contract to construct a fee schedule that accurately reflects the agreed upon terms and compares that to the fee schedule provided by your payor. As discrepancies are identified, Due North Analytics works with your organization to understand the revenue impact.
Second, by merging the derived fee schedule with payor specific utilization Due North Analytics quantifies the relevant revenue impact. Identifying which services and procedures drives your organization’s revenue allows for a broader understanding of clinical trends. Understanding overall payor mix with an equivalence analysis is the next critical step for decision makers.
Third, incorporating each payor’s expected revenue impact, Due North Analytics will prepare an equivalence analysis. The analysis will provide clear insight into how each payor’s reimbursement compares to one another at both a high level summary and at the procedural level. This information will provide your organization with the confidence and knowledge to negotiate competitive reimbursement rates.
- Fee Schedule Development
- Revenue Impact
- Equivalence Analysis
Due North Analytics develops and reconciles fee schedules to guide healthcare organizations of various care settings to maximize revenue and ROI.