Doctor-Payer Relations

Your practice’s relationship with payers directly impacts reimbursements and revenue. However, that relationship is built on understanding how your operating metrics convey the story of your practice and how payers interpret and share that data within their networks.

Every practice has a unique story.
We work with you to develop your practice data into a compelling story that will attract payers and, in turn, referring providers.

Payers Are Giving You a Scorecard (Whether or Not You Know It)

Payers are increasingly evaluating specialists on costs and outcome measurements. It is very likely that some of the payers in your area have scored your practice and created a scorecard that shows how they rank you.

These score cards may include cost / quality metrics, such as ASK utilization rates, cost per patient, encounters per patient, procedures per encounter, replacement readmits, etc.

These report cards will increasingly matter in determining the volume of referrals your practice receives in the future.

While it may be frustrating that payers reduce your work as a physician to a few simplistic numbers, the higher you consistently rank by a payer, the more likely you are to receive referrals.

Reviewing these report cards now, making necessary improvements, and positioning your practice as a trusted partner is crucial.

This is not just a suggestion but a necessity for staying competitive and maintaining a strong position in the healthcare market.

Technology to Power Modern Medical Practices

Modern healthcare is powered by data – an overwhelming amount of data. Our specialty practice solutions help gather and make sense of it all to give you the insights to:

Know and understand the key quality measures payers are using to evaluate you

Figure out how to capture and track those metrics

Determine what actions to take to improve your practice

Improving Payer Relations with Technology + Expertise

It all comes down to metrics. Everything in modern healthcare is tied to data: baselines, outcomes, patient satisfaction, efficiency, and financial performance. What matters is how you use this data to tell the practice story you want to payers.

Gather it All Together

We help you break down silos to uncover data-driven insights all up and down the patient journey—from referring physicians to post-acute care to claims status and payment data from payers.

Understand What You’re Looking At

We help you bring these pieces together—in a secure and compliant manner—so that you (and we) can adequately leverage the right data to tell your story.

Take Action

Once we help you uncover the metrics that matter, we will work with you to develop a custom-fit strategy to make impactful improvements, optimize operations, improve critical metrics, and tell your unique practice story.

At TRIARQ Health, we're committed to helping you strengthen your practice through improved provider relations so you can focus on providing the best care to your patients.

Want to know where you stand with providers and how they are scoring your practice?

Find out with a Comprehensive Practice Assessment that includes a clear roadmap for optimizing your practice's operations, understanding the competitive market, and identifying growth opportunities such as value-based care models.