Developing payer contracting resources

What are some of the challenges you have with payer contracting? What areas would you like to have more knowledge about? 


  • I am interested in how payer contracting intersects with government payers.  For instance, if I have an Anthem Medicare Advantage plan, do I bill it as our Anthem plan requires or as Medicare requires?  Are the medical necessity rules from Anthem or from Medicare?  How do I know?  What does Medicare require of their Advantage plans?
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