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Payor Baseline
A Payor Baseline allows your office staff to spot reconcile, at site, and flag EOBs that fall out of the baseline. Claims can then be worked more diligently to reconcile properly and re-submit as required. The payor baseline, once developed , sets the foundation for negotiation and review of new payor contracts, as well as, renewal of existing contracts with regard to their fit in
your current payor mix.

Another benefit of performing a payor baseline is to verify the efficiencies of your back office. In the event that a payor is reimbursing at the agreed upon rate yet the variance between billed and collected rates is substantially different This may identify inefficiencies in the practice and/or assist in establishing proper charges for CPTs based on your locale.

Performing a payor baseline can be labor intensive and time consuming, based on the number of contracted payors with the practice. Once a baseline has been performed additional payor contracts are easily analyzed and adapted to determine your collective, agreed upon, reimbursements. The outcome of the baseline can also be further utilized to assist in developing a cost analysis of your practice by physician and CPT. It may also be utilized to assist in future negotiations and trend analysis to determine market reimbursements over time.

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