The Reimbursement Effectiveness Platform
The Reimbursement Effectiveness Platform is a component of the Physician Empowerment Suite (PES), a suite of data analytics tools that aid practices and healthcare organizations of all sizes in enhancing operational performance, mitigating risk, improving reputation, and optimizing reimbursement. The RE tool leverages Patient Experience and Clinical Effectiveness data, contained in the Physician Empowerment Suite, to develop a “value story” for a practice. It also develops an analysis of payment levels for a practice’s top commercial payers. With this powerful, insightful, and actionable information, a practice becomes well positioned to drive performance within its practice and engage payers for enhanced fee-for-service and fee-for-value reimbursements.
The RE Platform contains three valuable components:
The Payer Portfolio Analysis
This benchmarking analysis tool displays payment rates for top commercial payers compared to Medicare and various other sources. By highlighting where practices are underpaid, they can create a fee-for-service, payer-specific strategy for top commercial payers. Practices can use this to leverage negotiation for increased fee-for-service rates and overall payment rates.
The Value Story
This report helps quantify a healthcare provider’s value to key stakeholders in the market based on various aspects of patient care and practice operations. A report will be automatically developed highlighting areas where the organization thrives or needs improvement, among other supporting performance data.
The Video Resource Library
This database of instructional videos walks users through a variety of topics, including:
- The changing landscape of healthcare
- The steps to better leverage for negotiation with payers
- Elements of value-based pay
- How to prepare a Payer Portfolio Analysis and use it to negotiate with payers
- Expert knowledge on reimbursement topics
- How to optimize use of the Physician Empowerment Suite (PES)
With only three simple steps, the SE Healthcare team makes it easy for you to implement the Reimbursement Effectiveness Platform into your everyday operations and optimize payments.
- Your team pulls data together in a file format that we provide.
- The system guides your team step-by-step through the process of uploading the file and entering summary information.
- A Percentage of Medicare report and a Volumes report are generated, allowing your practice to see where payer negotiations can be most effective.
The Reimbursement Effectiveness (RE) Platform helps private practices determine and articulate their value in the market to earn increased reimbursements from payers.
The SE team is here to support you throughout the process to make sure you achieve optimal results. It all kicks off with a brief 15-minute orientation call to discuss the best way to set up your new account and answer any questions you may have about the onboarding process. Our team is available to help make your onboarding process a simple one and help guide you through various process. Digital tools like an online demo are also available to enhance the process and empower you to more easily self-onboard.