video iconComplimentary On Demand Webinar


Negotiate Favorable Payer Rates with Transparency Data

Earn 1 AAPC | PAHCOM | PMI CEU

Unlock the power of CMS Price Transparency data to enhance negotiation strategies, and help secure favorable payer contracts.

CMS’s Price Transparency and Transparency in Coverage rules require hospitals and payers to publicly disclose their negotiated rates for all services to increase market competition and drive down the cost of healthcare services. However, due to the lack of standardization, numerous required fields and lack of clarity surrounding these requirements, it is cumbersome to navigate the disparate data and risky to compare negotiated rates for “like” services. This session will dive deep into how transforming the raw, machine-readable file will improve the comparability of negotiated rates and provide a strategy for hospitals and health systems to level the playing field with payers.

Key Learning Objectives:

  • Understand the national statistics and recent CMS actions around price transparency, and the pros and cons of using payer machine-readable files.
  • Learn how to improve the usability of negotiated rates for ‘apples-to-apples’ comparisons through reclassification of payers and standardization of disparate data.
  • Pinpoint areas of opportunity where negotiated rates are lower than those of your peers at the payer, product/plan, patient class and service line level.
  • Calculate your negotiated-rate position in the market and gain a competitive advantage to drive increased reimbursement

Govind Goyal, President Financial Services leads Panacea’s team of financial and revenue integrity experts who strategically partner with hospitals, health systems and other providers to grow their financial and revenue integrity performance, and to comply with recent CMS Price Transparency and other regulations through the use of technology.

Meet the Presenters

Natalee Hall
Presenter

Govind Goyal
Presenter
President, Financial Services
Panacea Healthcare Solutions

Kevin Chmura
Moderator
Chief Executive Officer
Panacea Healthcare Solutions