The Dilemma of Decreased Reimbursements

Throughout this blog series, we’ve talked about a lot of aspects regarding optimization of scheduling, and of the healthcare industry as a whole. Our posts have been centered around how to run the most efficient organization possible. Optimization is all about the strategic use of resources, even if they’re beyond the scope of physical materials or hired staff. So far, we’ve looked at these things from the perspective of scheduling operations/controls, how to utilize data to optimize your physician’s schedule, and most recently, how to go about reducing physician burnout.

This week, our goal is to look at something that I’ve gained an immense amount of knowledge of and appreciation for since entering into this industry, and that is:

Health Insurance Carriers and Reimbursements.

Obviously differing patient visit types will have differing associated revenue, but what can you do – as the physician or the scheduling staff – to make sure that you are helping your practice where reimbursements are concerned?

While insurance goals will undoubtedly be different based on each practice, physicians understand that decreased reimbursements are a source of stress. The strain that comes with the cost of running a practice, combined with an overall decrease in insurance reimbursements can alter the ability of a doctor to provide care for patients.

Past data can indicate a number of factors that could help explain why your practice might be feeling the effects of decreased reimbursements, as well as what could be the cause. It’s important to understand this data from a practice level, to an individual provider level, all the way down to the specific CPT level. Once you have a clear picture of what insurance payouts you are receiving, Opargo can be configured to prioritize based on whatever criteria is going to help your practice meet its goals.

Navigating the waters of insurance carriers seems overwhelming, and probably like it’s out of your hands entirely. But with Opargo, you have the ability to gain more control and insight into what your reimbursements have looked like in the past. With this new perspective, you can make prioritization decisions regarding what you want reimbursements to look like in the future.