RPM Billing LLC Announces Insurance Contracting Service Line


RPM Billing is excited to announce our new Insurance Contracting service line.  We are thrilled to be helping healthcare providers successfully navigate the maze of constantly evolving processes that is involved with carrying out an effective insurance contracting strategy.  While we have been doing this type of work with excellent results for our billing and consulting clients for years, we are excited to be delivering it as a separate service line now as well.  Of course, our billing clients always receive our contracting and consulting work for free.  RPM Billing's insurance contracting clients see their revenue boost and then stabilize for the long term when we work with their insurance companies to develop better reimbursement rates, more evenly-worded terms throughout the contract, and a stronger and more positive relationship with each insurance company.  

Here at RPM Billing, we specialize in all areas of the insurance contracting process, including planning and analysis, negotiations, and closing the deal.
— Jonathan Marshall, MBA, President of RPM Billing LLC

Insurance contracting strategies aren’t just about the reimbursement rates, and so our first step is to work with our clients to develop a more complete vision for the relationship between the provider and the insurance companies.  Beginning with the end in mind is how we approach the time we spend with our clients getting ready for the negotiations.  As the Healthcare Financial Management Association points out in their recent article titled “Successfully Negotiating Managed Care Contracts”, (http://www.hfma.org/Content.aspx?id=16658) developing a payer profile is a good way to organize and analyze our clients’ internal data on each insurance company.  Here at RPM Billing, when we do insurance contracting, developing a payer profile based on detailed analysis of many key factors has always been part of our standard process.  This includes compiling into one document each insurance company’s contract terms, their contracted reimbursement rates, and their actual reimbursement rates from their billing systems, including denials, and doing all of this by CPT code.  This helps us see the details of how each insurance company is treating our client, how well they are actually paying for each service, and what the real volumes are for each contract.  This crucial analysis allows us to work closely with our clients to value each contract and prioritize our approach. 

We include many key factors in the payer profile, such as:

-          Reimbursement rates at a CPT code level, compared to Medicare and Medicaid

-          Size of each insurance company in the provider’s market

-          Availability of quality incentive programs

-          Timely filing limits and payment takeback limits

-          Ease of contract termination

-          Contract terminology compliance with all applicable laws and regulations

-          Ability to add new services, providers, and locations

-          Ability to retroactively increase reimbursement rates

-          Ability to clean up issues that are persisting in the client’s aged AR

-          Genuine helpfulness and flexibility of insurance company and its employees

After compiling and organizing all of this information, we review it with our clients to come up with our plan of attack.  We prioritize the contracts and issues to attack first, and we work to understand where we are willing to settle and where we are willing to terminate and walk away if needed.  Once this plan is set with our client, we move quickly to start the process with each insurance company.  One of the features of insurance contracting work is that each insurance company has its own unique contracting process.  Some are very easy and user-friendly, while others seem as though they were designed to deter anyone from trying to renegotiate.  Our clients benefit from our successful experience in navigating all of these types of processes. 

Here at RPM Billing, we specialize in all areas of the insurance contracting process, including planning and analysis, negotiations, and closing the deal.  Our fee can be structured on an hourly basis or as a small percentage of the expected first year’s increase in reimbursement, which allows our clients to have a nearly infinite ROI as the increased contracted rates survive for years to come. 

RPM Billing is a medical billing and consulting firm based in Las Vegas and Reno, Nevada, serving doctors, hospitals, and other healthcare providers nationwide. We have an experienced billing and consulting team, and we work closely with our clients to make sure 100% of their bills get paid appropriately and timely. Led by Jonathan Marshall, who holds a Healthcare MBA and two decades of experience as CEO, CFO, and COO of hospitals and physician practices, RPM Billing was created as the answer to all of the overpriced and underperforming billing offices out there. We are 100% committed to excellent service, processes, bottom line results, and ethics. To contact us for a free review of your company’s opportunities to improve revenues, please call us at 775-501-9820, email us at jon@rpmbilling.com, or visit us at www.rpmbilling.com. Thank you.