Payer Agreements are changing, and the language is getting much more aggressive. I just saw new language that allows the payer to LOWER a provider’s reimbursement by 20% if referrals are made to other providers who are Out of Network. For example, your reimbursement would be taxed 20% if you take a case to an out of network ASC, or use an out of network surgical assistant.
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About R. Todd Welter • MS, CPC
Founder and President of RT Welter & Associates
Mr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment. Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.