Why track policy changes?
Often, the signing of a managed care contract is only the beginning of a long
and complex relationship with an insurance company. The pace of policy and
procedural change has accelerated greatly in the last few years due to changing
affiliations and merger-acquisitions, not to mention new products such as
consumer-directed plans, there is much change to manage, and particularly if
you participate in more than one or two networks at the same time. Moreover,
aggressive tactics by insurance companies are designed to minimize their costs
while eroding your bottom line and adding administrative complexity to your
practice. Physician reimbursement can only go so low, but constant changes to
policies and procedures – by which you are contractually bound and must abide –
guarantee that more premium dollars stay with the insurers and less
reimbursement goes to you. In order to respond and plan appropriately, you'll
first need to know about these changes, and more importantly, know how they
will affect your practice.
Where do we come in?
Until now, no-one has been monitoring these activities cohesively, let alone
alerting you about them. Without that level of transparency, you’ve been
operating in the dark. The Alert system puts the right information in your
hands, in a way you can use, allowing you to minimize costs and streamline
operations, while protecting your bottom line.
While most insurance companies with which you participate notify you of changes
affecting their network, these notifications are often posted on web sites, or
issued in monthly and quarterly updates to policy and procedure manuals well
after they go into effect. If you don't know a change is coming, you don't know
to look it up on the web site. If you wait for your monthly or quarterly
updates, you may find out about a change that has a severe impact on your
practice long after the change has occurred, resulting in days or months worth
of unreimbursed services. Not knowing about these changes can seriously affect
your revenue and hamper your plans for growth in the future.
How do we do it?
Verden Alert notifies you of changes - specific only to your participation and
your specialty - as and when these changes happen. Once we have your profile on
file - specialty and insurance company participation - we will be able to keep
you alerted and up-to-date about any changes affecting your practice.
Everyday we monitor more than 70,000 web pages owned by 170 managed care
companies for changes to policies and procedures affecting physician networks.
We record anything of relevance, cataloguing information by specialty and
classifying items into administrative, clinical, reimbursements and pharmacy
categories. Every night, our system issues Alerts automatically to our
subscribers. These Alerts are designed to be read in a matter of seconds, with
information indicating the company, title of the information piece, overview of
the material, the date it takes effect, and a hyperlink that takes subscribers
to the insurers’ sites in case more information is required.
What the Alerts do for you
When you register, you can subscribe to all four categories (administrative,
clinical, reimbursements and pharmacy) or select only the ones you wish to
track. Additionally, you can assign different categories to different email
addresses, so the right people in your organization get the right information.
Don’t think that because you use a billing service you don’t need to be a
subscriber. You will need to know about other equally important information
that affects how you do business at every level of your practice.
For example, not knowing about administrative changes such as procedures that
get added to notification or preauthorization lists and other day-to-day
process changes can cost you money, especially if you are waiting to find out
about it on your EOBs. You also need to know about clinical changes, such as
being able to administer Flumist to pediatric patients that previously were not
covered, or previously covered procedures that are now only eligible if
performed in an in-patient setting. Pharmacy changes are fast becoming
unmanageable, with many former drugs requiring medical pre-approval or removed
from formularies altogether. The alert system makes sure that you receive the
right information at the right time and that it reaches the right people in
your organization best suited to act upon it.
