Managed Care Services
Navigating the world of managed care reimbursement can be tricky, especially when adding new services and codes to a practice's operations. The IDC Managed Care Services team, made up of experienced healthcare administrators, works tirelessly on the practices' behalf to encourage appropriate reimbursement for procedures performed at our facilities.
We maintain contact with major payors in each of our markets, monitoring which payors will and will not allow these services to be billed by practices as in-office procedures. This helps us provide the most accurate estimates of patient "portability," so that lease volumes are based solely on those patients for whom procedures will be reimbursed adequately.
We also market the full benefits of the IDC solution directly to these payors, working for full acceptance and appropriate reimbursement rates.
At the outset of our relationship, we contact each practice's specific payors on their behalf to confirm that each practice's contracts will recognize and reimburse these services as in-office procedures, and identify reimbursement amounts for each applicable CPT.
We help practices develop an appropriate fee schedule for these new services, based on local reimbursement rates.
We provide ongoing consultation on coding and billing to ensure procedures are reimbursed fully and accurately. As part of this process, we review and analyze initial HCFAs for accuracy; we also evaluate EOBs to compare actual payment experience against initial payor contact information, assisting practices with follow-up as needed.