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Steve Selbst

Three key items to negotiating successful payer contracts


The purpose of this article is to help you, as a provider, to hone in on three key items to look for in payer contracts that will help you to get profitable contracts in place.

Contracting: Understand different programs

Q. What are the different types of VA contracts?

A. Most HME providers understand that the Department of Veterans Affairs provides healthcare services nationwide for America’s veterans and that in addition to having facilities across the country, the VA has additional methods to provide timely, high quality care to veterans.

Contracting: Set your chargemaster

Q. How can I not get bitten in my payer agreements?

A. One of the most common and often misunderstood potential hazards in payer contracts is the “lesser of billed charges” language found in almost all contracts.

Contracting: Beware these contract pitfalls

Q. What are some red flags in payer contracts?

A. In addition to contracted rates, there are key items often found in payer contracts that can significantly affect and often reduce reimbursements. Here are a few to look for:

Contracting: Offer best value proposition

Q. How can I get contracted into closed and narrow networks?

A. It is often challenging for HME companies to get contracted with payers. Payers often close their networks to new provider applications once they reach a certain number of HME companies. 

Healthcents makes sense of managed care

‘There’s a lot of innovation that DME companies can bring to bear,’ says CEO Steve Selbst

SALINAS, Calif. – Healthcents has watched as HME companies—not only providers, but also distributors and manufacturers— have become 60% to 70% of its customer base, replacing the medical practices that were the bulk of its business 10 years ago.