In Episode Three of the Best of Cash is King, AADGP President Dr. Brent Barta and Vince Cardillo, Founder & CEO of Maeva Dental Advisors discuss ways to maximize the Payor Contract process for a small emerging practice.
Dr. Brent Barta
Vin you deal with some smaller emerging group, how would you advise a small group to, you know, systematize, this process a group that doesn’t have a full-time person, working on these, payor contracts, any basic processes that you would put in place in a small emerging group.
Yeah, I mean, I think it’s a, you know, you could do it annually right, it’s an annual process or, you know, twice a year because, you know, sit down with your, your practice manager, or your operations person and just pull the data of your, UCR and put it up against each, one of your payors fee schedules, and take a look at those and you make the calls to the insurance companies and say, hey, look, you know, I just did an analysis here. Our UCR is at seven?
Five percentile. and, you know, even with that, our discount is 51 % on these procedure codes and it’s important, like George said to look at each procedure code because, you know, they’re happy to increase procedures that they know you don’t use, they’ve already done the analysis that you need to be doing. Right, so it’s not a matter of saying, hey, you know just increase our fees across the board.
It’s important for you to say. Hey, look what you know this this, you know root planing and scaling the 4341. It’s just not there and you may be more likely to negotiate five of your top 20 procedures. And you know, it’s always the 80/20 rule, 20% of your procedures, 80% of your production and vice versa. So if you can, if you can increase those again the insurance Company knows that also but if you can have the knowledge that they have, you can have a meaningful conversation and, you know, there’s nothing wrong with weeding, the lower payers out of your system.Again, assuming that your schedule is at capacity in your office, is at capacity.
Dr. Brent Barta
I agree with a great advice.