Fee Schedule Development & Maintenance

Coding, billing and collection efficiencies impact your bottom line only to the point where you collect the payment negotiated in your third party payer contracts. Too often, practices accept a third party payer's standard reimbursement rates or an amount only marginally above the standard rate. In some cases, the payers' standard reimbursement rates are even lower than the Medicare fee schedule.

Typically, it is much better to secure higher reimbursement rates initially and ask for smaller increases at renewal than to accept low rates up front expecting to negotiate larger increases later. The MRI team has experience with payers and understands their negotiation processes. As our client you can leverage our knowledge and use your practice's strategic importance to secure higher reimbursement rates. We have negotiated significant rate increases for many clients from the largest payers in their region. And, we have achieved these results for clients whether they were participating with payers for the first time or had long contract history. Depending on your practice's specific payer mix, MRI's negotiated rate increases can improve bottom-line revenue. We will be happy to negotiate on your behalf or review any third party payer contract your practice may be considering.

Overall reimbursement rates can be positively impacted if you have a complete and appropriate fee schedule and sound fee schedule policies. When it's time to establish or update your fee schedule, you can rely on the insight of the MRI team to help identify the methodologies that will work best for your practice and guarantee compliance.

Whether you prefer a relative value unit (RVU) reimbursement or cost-based charge setting methodology, our experts will help you develop the right fee strategy to capture the maximum reimbursement possible. And because there are many myths in healthcare related to fee schedule development and compliance, MRI will share with you the most current regulatory references regarding fee schedule policies and work to develop a fee schedule that complies with your specific State regulatory parameters.

Additionally, our access to national and regional databases allows us to provide charge recommendations that are specific to the major insurance carriers in your area, as well as your local market. By continually monitoring specific insurance carrier profiles, we provide you with the data needed to support fee increases. We provide the following:

Our Revenue Cycle Management includes:
  • Payer registration, credentialing, contracting, and enrollment services
  • Comprehensive medical coding with CPC certified coders
  • A/R management, denials management, payment posting
  • Document Management
  • Credit card and check processing
  • Patient billing and inquiry management
  • Reporting and analytics

Related Articles

About MRI

Since 1988, MRI has offered comprehensive Billing & Receivables Management Services that create superior coding, billing and collections outcomes for hospital-based providers.

In addition to Coding, Billing, Collections, Denial Management and Auditing services, MRI offers clients value-added services such as Third-Party Contract Negotiation and Fee Schedule Development & Maintenance assistance.

All services capitalize on MRI's unsurpassed knowledge of the entire healthcare revenue cycle to deliver workable recommendations and tangible results that have improved the bottom line of every single client.