Not happy with your Medicare plan? You have options

Medicare is a huge system with many, many options that all seem confusing. Even after enrolling, you can run into problems, such as deductibles or co-pays that are higher than expected, or perhaps your primary care physician is out of network. For people on limited incomes, this is a serious concern.

Never fear. Medicare gives people an opportunity to change plans. From January 1 to March 31, anyone enrolled in Medicare or Medicare Advantage can switch plans instead of waiting an entire year for open enrollment to come around again. There are a variety of reasons to switch, but only a limited time frame to do it. And, being such a big system, it takes time for changes to go into effect.
Which plan is best for you? That answer is different for everyone, but the one thing you can do is become familiar with Medicare.gov. It includes information about every plan and helps you manage your health information, and it should be the first stop in determining what plan works best for your income and lifestyle.

On this episode of the Pulse, Keith Leitzen, President of Managed Care Partners, shares his expertise with the Medicare process and breaks down exactly what Medicare recipients and their children should know about the enrollment process.

Presented by: Perry Memorial Hospital

Patient Satisfaction

Patient Satisfaction

Patient satisfaction is no longer something that can be taken lightly by any health care provider. The dreaded negative Yelp review or low Healthgrade score is not just insulting, it has a direct impact on potential patients. An Internet search to find a new provider is standard these days, and negative reviews turn people away. Patient satisfaction impacts far more than attracting new patients. Payers are using patient satisfaction surveys to determine reimbursement or penalties if certain levels of satisfaction are not met.

So what is a health provider to do? Take affirmative steps to increase your scores on patient satisfaction reviews.

Here are a few places to start:

Talk with your happy patients. Ask them to post positive reviews on sites like Yelp and Healthgrades and to fill out the payer patient satisfaction surveys when they receive them. Unhappy patients are more likely to post a negative review, so remind your happy patients how much their positive words mean to you and your practice.  

Keep in mind, it is not just the health care practitioner patients are reviewing. Everyone from the person setting appointments to individuals in the billing office impact the patient’s experience. Set a positive example. An upbeat, positive tone where kindness and courtesy are emphasized and patient’s time is valued, will go a long way in overall patient experience.

Set realistic expectations for patients. If you can, provide literature about your office’s policies and procedures and keep your website and patient portal up-to-date. Patients should know ahead of time the time how long it takes to receive a prescription refill and/or test results. Keeping patient expectations in step with their actual experiences will lead to happy patients and positive reviews.

These are a few ways your practice help improve its patient satisfaction survey scores, but there are many more.  If you would like more ideas, please contact Managed Care Partners.

Analyze your current reimbursement rates

Analyze your current reimbursement rates

For many of us, a New Year means creating resolutions or to-do lists. If you run a medical practice one of the things on your to do list should be to take a look at and analyze your current reimbursement rates. If you can gather enough information, you may be able to negotiate better rates.

Sadly, approaching a payer asking “Please may we have an increase?” is unlikely to be successful, even if you say please.  Instead, you need to take a reasoned approach, providing specific data and give the payer a reason to increase your rates.

Here are a few steps you can take to increase your chances of a successful rate increase negotiation:

  1. In order to negotiate better reimbursement rates you need hard data to prove your case. Go over the last six months to one year of your billing history to determine what codes your organization bills the most. Once you compile that data, decide what you want the reimbursement for those codes to be. It is best to focus on specific CPT codes, as payers are most likely to allow for increases to specific codes than an overall rate increase to the entire contract.
  2. Organize this data in a fee analyzer or spread sheet. You want to have information that you can easily present to payers.
  3. Be prepared to explain to payers why your organization is an asset to the network and to demonstrate your value over other provider organizations. You want to be able to give them a reason to up your reimbursement. The high quality of your services, accessibility for new patients, meeting geographic or specialty need are some assets you can focus on.
  4. Once you have your easy to read spreadsheet and a list of reasons why your organization is valuable to the network, reach out to your payer representatives and make your case, beginning with the payers with the most volume.

Remember, even a slight increase to the reimbursement of a frequently billed code can result in a significant increase to your bottom line.  If you are unsure as to how to begin this process, one of our experts at Managed Care Partners can help.