Healthcare is a growing sector, which means that there is a growing need for contractors of all kinds in this sector. Finding a company that understands your needs and that has the necessary expertise to meet those needs is not a cakewalk.
To find a company that understands your needs and can meet those needs, you need to know the right questions to ask. This article discusses some of the key questions you need to ask to find the best payor contracting company in your market.
What is a payor contracting company?
A payor contracting company is a specialist firm that works with health insurers to help patients with medical bills, either by collecting the bills or by covering them when a patient cannot pay them.
They work with a range of health insurers, including Medicare Part B providers, Blue Cross, and Blue Shield (BC/BS) plans, as well as other providers, such as health maintenance organizations.
Additionally, some payor contracting firms also accept employer-sponsored benefits, such as group insurance.
There are two types of payor contracting firms:
- Billing and collections: These firms help hospitals and other health providers bill patients for care, and then collect the money for them.
- Coverage and underwriting: These firms help individuals and small businesses buy medical insurance, and then either cover people with pre-existing conditions who cannot get coverage elsewhere, or underwrite their policies, which means they charge a premium to cover people with serious medical conditions.
Verify What You’re Looking For
When looking to hire a contractor, one of the first things you’ll want to do is make sure you’re hiring the right contractor. To do this, you’ll want to make sure you’re hiring a contractor that meets your needs, as opposed to hiring a contractor because they meet your needs.
Here are some red flags to watch out for when searching for the best payor contracting company for your needs.
- Willingness to work with Medicare providers: While some payor firms accept all Medicare providers, most only accept Medicare providers. If a contractor is willing to work with providers other than Medicare, this is a good sign.
- Experience: While contracting firms are becoming more common, many hospitals and other providers do not yet trust them enough to let their patients deal with them directly. It is important that you choose a contractor that has experience doing business with health providers, as this will help ensure that your provider has been vetted.
- Protection of PHI: It is essential that you choose a contractor that protects your personal health information, as this will help ensure that the contractor you choose is the right contractor for you.
Determine Why You’re Hiring
Once you’ve selected a contractor, it’s time to decide why you’re hiring them. As mentioned above, many payor contracting firms work with a variety of health insurers, including Medicare providers, Blue Cross and Blue Shield (BC/BS) plans, and other providers.
Ask About Processes and Tools
One of the key benefits of working with experts in payor contracting firms is the ability to leverage their extensive relationships with providers. This means that, if you choose to work with a payor contracting firm, they will likely have access to information about your case that other contracting firms do not.
One of the first things you’ll want to ask a potential contractor is how they handle data and process management. This will help you determine if they have the access needed to handle your case and if they have the processes and tools needed to handle your case.
Ask About Core Values and Culture
When hiring a contractor, it is important that you get a sense of the contractor’s values, culture, and what their team looks like. It is important that you feel as though you can work well with the rest of the team, as this will help you feel more secure as you work on your case.
It is also important to make sure the contractor you choose has core values that align with your values. It is difficult to hire the right contractor if you do not know what values the contractor has, and it is difficult to find a contractor that aligns with your values if you do not know what those values are.
For instance, you may want to choose a contractor with values that emphasize community health, as opposed to a contractor that emphasizes business-mindedness, as this will help you feel more comfortable as you work on your case.
Bottom Line
When hiring a contractor, it is important to make sure you are hiring the right contractor for the job. This means making sure you are looking for red flags, as well as making sure you are considering the contractor’s long-term commitment to working with you, as well as their track record and experience.