Payer Contract Adhesion – And What They Can Do For Your Revenue Cycle Audit

Every ambulatory surgery center (ASC) strives to manage its revenue cycle as efficiently as possible. Mistakes or delays in coding, billing, and collections can lead to financial challenges. No center wants to show a loss in revenue because of flawed revenue cycle management practices.

Regent Revenue Cycle Management encourages ASCs to perform three regular audits to detect and correct errors before they become larger problems. Regent RCM has created a new guide that details how centers can take simple, concrete steps to track and improve their revenue cycles:

  • Denied claim cause and management
  • Coding accuracy
  • Payer contract adhesion

Payer Contract Adhesion

In our third and final blog of our three-part series, we focus on why negotiating fair payer contracts – and making sure that all terms are met – is a critical part of revenue cycle management.  Your revenue cycle team needs to know every detail of their contracts, so they can fight for every dollar.

Regent RCM advises centers to conduct an audit on each of their payer contracts to understand what the contract says, what their center is allowed to bill, and how they can avoid over- or under-payments. The ultimate goal is for ASCs to receive exactly what they are owed – no more and no less.

When negotiating a contract, Regent RCM recommends following these five steps:

  • Start at least four months before the anniversary of the contract
  • Check the terms of the contract carefully
  • Build relationships with payers
  • Be aware of evergreen contracts that roll forward without renegotiation or a termination date
  • Keep all contracts current to make sure they aren’t falling behind

Learn how to perform our three audits to enhance your ASC’s financial performance. Download the guide here.