Payer Relationships Matter!


There are numerous possibilities for malfunction in the medical billing apparatus.  Human error, technical issues, miscommunication, overwhelming volume – these are all commonplace.  However, there are preventative measures that your organization can adopt to minimize the negative impact these billing issues have on timely payments.  One of the most effective, yet often overlooked, actions your organization can take is to create and maintain a positive relationship with your payers.  Here’s why the working relationship between payer and provider is so important:



Payer networks, as disparate a group as they may be, are a network nonetheless – a negative reputation as being uncooperative, rude, or difficult will spread – which could negatively affect contract negotiations or a payer’s willingness to work with your organization.


Billing is rarely a straightforward process.  Errors, exceptions, denials, and assorted complications are all par for the course.  Fostering a relationship of patience and understanding will result in a cooperative one, allowing for the unavoidable oddities you will encounter in the billing process.  Additionally, a payer with a positive opinion of your organization is far more likely to grant requests for extensions, process overdue claims for payment, and make case by case exceptions to their policies for the benefit of your organization.



You can circumvent the red tape and bureaucracy associated with Medicaid payer networks by establishing personal connections and friendships with payer staff.  This can significantly expedite any troubleshooting, technical issues, etc., which can help dramatically to avoid delays in regularized billing.

Always be courteous and friendly in every interaction with your payer network.  Comply with payer procedures and standards to the best of your ability, attend any payer-organized training seminars/meetings you can, and make every effort you can to avoid billing errors.  This “good faith” behavior is the foundation of a healthy relationship with a payer.  A healthy relationship with a payer will facilitate timely payments, flexibility with payer billing procedures, and quicker resolution of problems.  Cooperate with your payers whenever it’s possible – your cooperation will be rewarded! Your biller owns these relationships. Make sure they know how to do a great job. Red House Medical Billing is always ready to help if you need us. By visiting our site you can contact a professional biller.



Joseph DesOrmeaux leads a medical billing team for a multistate behavioral therapy provider based in Novi, MI.  He specializes in generating billing strategies for new payers and allocating professional resources for regularized billing of payer networks. He is also a gummi bear connoisseur, and will discuss the subject at length given the opportunity.

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