We don’t take “No” for an Answer- Success Story Part 2
If you are like a surgical wound care organization that we recently partnered with, your medical facility is meeting a real need in the medical community- one unrecognized by health plans. Without the partnership with United Physician Services, their value might have continued to go unnoticed, but the story doesn’t stop there. Find out more from United Physician Services about how yours can be recognized, too.
No Need for your Services? Vital medical services are often rejected by health plans for reasons that have nothing to do with the significance of the service. In fact, health plans often tell practices that they don’t have a need for their services when the health plan simply doesn’t understand the business model. In addition to this, medical practices are often denied contracts due to the fact that health plan professionals aren’t interested in doing the work to obtain the very documentation they would need to evaluate the evidence and thereby prove its validity.
We do the Health Plan’s Work for them. When a client comes to us and demonstrates it is providing value to the health plan, we commit to do the work for the health plan and document the client’s value and clarify the business model. With over 25 years years of experience negotiating payer contracts and navigating reimbursement and payment issues for clients, United Physician Services leverages a knowledge base to fight for our clients when health plans should be saying “Yes” to them.
We Prove the Value. A significant government health plan was telling our client that there was no network need for their valuable service—one which only two physician groups in the nation provided—one of them being our client. We were able to prove the value that our client brought to the table by providing the statistics and current research the health plan was looking for in the language they understood. However, this wasn’t easy.
We don’t Settle for Rejection. Just as is the experience of many of our clients, we were initially declined. However, we didn’t take “No” for an answer. Getting the large government health plan to agree to overturn their decision was no easy matter. Nevertheless, our confidence in our client’s value gave us the tenacity to keep on fighting until we got a “Yes.”
Millions of Dollars can be at Stake. This “Yes” could mean millions of dollars in additional revenues for our client per year. Just think about it- your practice could be making hundreds of thousands- even millions more if you acquired those contracts you have not yet been able to secure.
How can United Physician Services Help?
Getting your Value Recognized: What many medical practices are unaware of is that they might not be using the specific language and evidence a health plan is looking for in order to support their value. Even if your practice goes a step further and isn’t able to articulate your value, United Physician Services can assist you with not only defining it, but with communicating it in a value proposition that the health plan can understand and get behind. We will do the research necessary and continue to demand reconsideration even when we are rejected.
Earned Respect with Health Plans: Due to our honesty and resolve to take only clients we believe we can assist, we are respected by and have wonderful relationships with Medical Directors, V.P.’s, Directors and Managers at health plans across the country. With these solid, time-built relationships, we have been able to learn what they are looking for and develop a formal proposal template that presents our client’s value with the language and data health plans desire. Through these templates, we are seeing 85% success rates in securing contracts.
Does your Medical Practice have Unsecured Contracts? If you are like many reputable practices out there on the front lines meeting real needs but suffering from lack of reimbursement, our qualified senior contract negotiators are ready to discuss a customized solution. Find out what value we might be able to bring to your practice. Schedule your Free 30-Minute Consultation Today!
Want to Know More? To read more about how United Physician Services turned Advantage Wound Care’s dilemma into a success story, check out “Contract Secured-Success Story Part 1” and stay tuned for “The Right Words to Up your Reimbursement- Success Story Part 3”