FAQs

Q: How do healthcare groups benchmark commercial payer reimbursement rates accurately?
A: Healthcare groups benchmark by analyzing actual negotiated allowed amounts from payers across specialty and geographic peers. Using data analysts like Tribunus Health, they compare rates against competitors to identify gaps and opportunities for contract optimization.

Q: What specific reimbursement data should medical practices collect before negotiating payer contracts?
A: Practices should gather allowed amounts per payer and CPT code, competitor rate comparisons, payer mix data, utilization metrics, and historical contract results. This comprehensive data foundation supports effective negotiation strategies.

Q: How often is the reimbursement benchmarking data updated?
A: Tribunus Health updates its benchmarking data monthly, incorporating newly published payer data across all billing codes and states for up-to-date market visibility.

Q: How does Tribunus Health’s benchmarking data differ from claims-based estimates?
A: Tribunus Health provides actual negotiated allowable amounts rather than proxy estimates from claims data, offering more accurate and reliable benchmarking that reflects true reimbursement patterns.

“As a startup provider organization with ambitious growth targets, managed care contracting was critical for us. Tribunus Health successfully negotiated health plan contracts which gave us access to 99.7% of commercial insured patients and 88.1% of managed Medicare patients in our state on an in-network basis. Tribunus is an ideal partner for growing healthcare organizations.”

Cheryl, Medical Optometry America