decisionhealth Newsletters, Part B News - 2011 Issue 11 (November)
5 steps to rank your payers’ performance
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Article Overview
This article is about evaluating and ranking health plan payers using operational and financial measures drawn from practice management and accounting systems. It is intended for medical practice administrators, billers, revenue cycle staff, and analysts who want a structured way to compare payer value and administrative burden. The article covers a stepwise approach to building a payer scorecard using broad performance metrics and combining them into an overall ranking.
Why This Topic Matters
Payer mix affects both revenue and administrative workload, so practices benefit from a consistent way to compare payers beyond patient volume alone. A clear ranking approach can support payer management, contract review, and revenue cycle planning.
What You Will Learn
- How to compare payers using financial and administrative performance measures
- Which practice data sources can support payer analysis
- How to assemble a simple payer scorecard for ranking purposes
- What broad categories of metrics are commonly used to assess payer value
Who Should Read This
- Medical practice administrators
- Billing managers
- Revenue cycle staff
- Practice analysts
- Physician office managers
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