payer mix

payer mix

Medical practice The type–eg, Medicaid, Medicare, indeminity insurance, managed care–of monies received by a medical practice. Cf Patient mix, Service mix.
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Although it is clear that the coverage expansions were associated with sharp changes in payer mix, (2-4) less is known about changes in payer-specific utilization rates, how the magnitude of such changes varied with the size of the population targeted by the coverage expansions, or the impact of the expansions on utilization rates of various age/sex demographic groups.
It Is unclear how this care will be Integrated Into practices that serve patients with a large payer mix, though It seems to be a natural progression of the Comprehensive Primary Care Plus (CPC+) model practices.
In the industry that payer mix represents a serious financial challenge.
The payer mix at hospitals is also a factor in employing doctors, analysts say.
The industry benchmark is typically 30 days, with variation by specialty and payer mix. This is one of the best indicators of performance of the revenue cycle; regular monitoring can provide insight into the revenue cycle efficiency.
Analysis of the laboratory's payer mix for patients with lung cancer and review of the major payer's coverage policies for 81445 is recommended.
'Many US-based physician practices cater to patient populations that represent a diverse payer mix. These patients - coupled with others who are enrolled with either co-pay or high-deductible health plans - pose critical challenges to practices that often fail to manage and collect patient dues on time.
Providers should carefully select potential networks based on availability (can they join the network at all?) as well as their current patient and payer mix. How much business the provider already does with an insurer (or how much business they may be turning away because they are out-of-network) can guide that selection process.
This includes an in-depth make-versus-buy assessment to help your lab understand both the costs of performing tests (to include both supply and labor costs) as well as the profitability of those tests by determining payer mix and payer rates.
The district provides essential water and sewer services to a fast growing suburban Riverside County, California service area with a diverse payer mix and a fundamentally sound but development-dependent economy.