By Steve Selbst bio It is important to remember that payers are large companies, with protocols, policies and business practices. As with any large company, there are bureaucracies, and they are necessary to maintain the order and success of these organizations. Therefore, the first tip is to understand that to get contracted you need to identify the right department and right person to send your request to get contracted. This is usually the payer contracting department and payer contracts’ manager. Generally, you will be sending your requests to the payer contracts’ manager in your state. A common mistake is to—instead—send these requests to provider relations or to another department. This brings us to our second tip. That is, figure out the approach the payer is using to establish its fee schedules and negotiate your agreements based on the payer’s methodology. Some payers establish a percentage of local Medicare rates based on specific code groupings. There may be a pre-set rate for each code or perhaps the same rate for code groups. I have seen national payer fee schedules that price E and M codes at a specific percentage of Medicare and another rate for laboratory and pathology codes and several […]