Payer Strategy
Strengthen payer-provider relationships through accountability and collaboration
Relationships between payers and providers are complicated; RemedyIQ provides a framework to strengthen them through transparency to achieve more efficient claim adjudication for all.
Improve claim adjudication
Streamlined communication and workflow modifications reduce claim denials and accelerate processing times, enhancing cash flow and financial stability.
Enhance payer relations
A structured governance program fosters transparency and collaboration with payers, leading to a more cooperative, less adversarial relationship.
Keep payers accountable
Customized report cards with clear SLAs and KPIs hold payers accountable, improving key metrics critical to financial and operational success.
A strategic approach to healthcare payer relations
RemedyIQ supports clients with the complicated relationship between payers and healthcare organizations. Strengthening these relationships through open communication, transparency, and collaboration can lead to a more efficient claim adjudication process for all parties.
What is Payer Strategy?
Payer Strategy is a service that helps healthcare providers improve relationships with payers by fostering collaboration, enhancing communication, and streamlining workflows to optimize claims processing and ensure timely, accurate reimbursements. This approach establishes clear accountability through governance programs, performance metrics, and data-driven insights.
How we can help:
- Establish a governance program that oversees internal/external payer communication, payer escalation, and technical workflows for account management.
- Foster a collaborative relationship with payer and provider teams.
- Identify mutually beneficial workflow modifications to streamline claims processing.
- Create payer report cards with agreed-upon SLAs and KPIs.
A structured governance program fosters transparency and collaboration with payers–leading to a more cooperative, less adversarial relationship.
Outcomes:
- Improved claims processing efficiency
- Strengthened payer-provider relationships
- Enhanced accountability
- Reduced administrative burden
- Optimized revenue cycle performance
Who is Payer Strategy for?
Any healthcare provider organization that experiences frequent claim denials, payment delays, or strained relationships with payers could benefit from Payer Strategy. It is especially critical for organizations seeking to improve cash flow, streamline claims processing, and establish accountability with payers to ensure optimal revenue cycle performance.
How does the process work?
RemedyIQ’s Payer Strategy solution follows a three-stage approach to identify challenges, implement tailored solutions, and ensure continuous improvement in claims outcomes.
Assessment
Comprehensive evaluation of existing escalation processes, communication cadences, and payer performance KPIs.
Strategy
Identify workplan of key areas for improvement.
Monitoring
Track payer performance against established benchmarks and refine processes to ensure sustained improvements.
Meet your RemedyIQ partners
With an average of 20 years in healthcare, RemedyIQ team members bring deep expertise from provider, payer, and consulting spaces - spanning revenue cycle leadership, contract negotiation, certified technical Epic support, third-party zero balance underpayment recovery, and more.
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