On this episode of The O&P Check-in: an SPS Podcast, we are joined by Jessica Norrell, CPO, MBA, owner of MOZN Solutions. She shares how O&P professionals can reassess their insurance contracts to increase profitability and patient access.
The following includes an excerpt from our conversation, edited for length and clarity. Click here to listen to the full interview.
The O&P Check-in: an SPS Podcast unpacks trends and stories from the tight-knit community of O&P professionals. From patient care to technology, best practices, and regulations, this podcast features topics that help you stay current.
What headwinds are O&P professionals currently facing with insurers?
Trying to get to current Medicare is a big uphill battle. We're small in the healthcare sector and we're one of the few professions that have negotiated rates below Medicare. When you're talking about physicians or hospitals, their rates are far above Medicare. So, we have a long way to go advancing our contracts in general.
What proactive steps could O&P professionals take to help get the most out of their insurance contracts?
The very first thing a clinician should do is create a contract management system to centralize all their contracts. Create a shared folder where the contracts are accessible online, and they're shared with the appropriate people on your team. Then use a spreadsheet to list every payer you have a contract with or work with. If you have a rep or somebody in that contract you've worked with, include them in that document, as well as your termination clauses. You should know things like the length of the contract and whether it auto-renews. That's where you want to start; just understanding where your contracts stand.
The next step is understanding the impact on your business. For example, you may have a really poor contract with a payer, but it’s only 5% of your sales, so maybe that’s not one you want to spend a lot of time on. There may be another payer that is 80% Medicare, but it’s over 45% of your sales. If you got 5% more or moved it to current Medicare, that would have a good impact on your business. I recommend prioritizing the largest and the most important contracts and then the oldest after that.
To hear the entire conversation, click here:
Learn more about Jessica and how MOZN Solutions can help you optimize your practice at moznsolutions.com and contact Jessica today!
Be sure to check out our previous conversation with Jesscia about the what, why, and how of SOAP notes.
