tci Medicare Compliance & Reimbursement - 2015 Issue 16
Hospital Billing Strategy: Develop Strong Business Relationships to Ensure Smooth Reimbursement Claims
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Article Overview
This article explains general best practices for hospitals, physician practices, ASCs, and multi-specialty groups that want to improve communication with payers and strengthen reimbursement workflows. It discusses relationship management, documentation, association membership, EHR and claims technology, electronic transactions, and maintaining professionalism in payer interactions. The piece is aimed at billing and revenue cycle staff, practice managers, and hospital administrators who want a broader understanding of operational approaches that can support smoother claims processing.
Why This Topic Matters
Effective payer communication and efficient billing operations can reduce administrative friction, support cleaner claims handling, and help organizations maintain steadier reimbursement workflows.
Article Sections
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Communicate and Document
Covers the importance of regular communication with payers and keeping records of those interactions. It also discusses internal contract management involvement in larger organizations.
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Be Part of a Larger Association
Discusses how association participation can support provider organizations through shared resources, professional management, and negotiation leverage. The section also addresses technology support in broader organizational settings.
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Use Technology Wherever Possible
Reviews general billing technology capabilities that can reduce manual work and support electronic workflows. It includes broad topics such as record handling, eligibility or demographic data retrieval, electronic claims, payment transfer, and online payer tools.
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A Good Rapport Goes a Long Way
Focuses on professionalism, courtesy, and long-term working relationships with payer organizations. It emphasizes the operational value of consistent communication and positive interactions.
What You Will Learn
- How payer communication fits into billing operations
- Why documenting payer conversations can support administrative follow-up
- How associations and shared resources can help provider organizations
- Which general technology functions are useful in reimbursement workflows
- Why professionalism and rapport matter in payer relationships
Who Should Read This
- Hospital billing staff
- Revenue cycle teams
- Practice managers
- Contract management staff
- Healthcare administrators
- Physician group administrators
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