{"id":1792,"date":"2015-03-17T12:33:31","date_gmt":"2015-03-17T12:33:31","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=1792"},"modified":"2026-03-26T00:52:46","modified_gmt":"2026-03-26T05:52:46","slug":"payer-matrix-checklist-for-medical-practices","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/payer-matrix-checklist-for-medical-practices\/","title":{"rendered":"Ultimate Payer Matrix Checklist for Medical Practices"},"content":{"rendered":"
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Payer matrix checklist for medical practices!<\/strong><\/h2>\n

Did you know that a hospital works with 1300 insurers on an average? And the fact that every insurer has different plans and regulations makes the insurance billing process extremely complex and ridden with tripwires. Has your medical practice been discussing about maintaining a payer matrix off-late? If not, it is high time you did.<\/span><\/p>\n

Tracking the payment pattern of insurers, identifying underpayments<\/a>, weeding out insurers who repeatedly deny or underpay claims is a tedious process. A payer matrix can help resolve<\/span> revenue cycle<\/strong> <\/a><\/span>issues and enable physicians to negotiate better fee-schedules.<\/span><\/span><\/p>\n<\/div><\/div>[vc_empty_space height=”20px”][vc_single_image image=”446257″ img_size=”full” onclick=”custom_link” img_link_target=”_blank” link=”https:\/\/www.billingparadise.com\/resources\/?utm_source=BP_blog_payer_matrix-13&utm_medium=Download”]

Here is a small checklist of what your payer matrix should consist of\u2026<\/strong><\/span><\/h3>\n

1. Contact information of contracting and credentialing representatives<\/strong><\/p>\n

2. Name and contact details of all your payers<\/strong><\/p>\n

3. The basic agreement structure of all contracts<\/strong><\/p>\n

4. Termination\/renewal dates of contracts<\/strong><\/p>\n

5. The coverage and documentation guidelines of payers<\/strong><\/p>\n

6. The deadlines and pre-authorization, pre-determination requirements of payers<\/strong><\/p>\n

7. The reimbursement rate for your medical practice\u2019s major CPT codes<\/strong><\/p>\n

8. The first pass claim acceptance rate of insurance companies<\/strong><\/p>\n

9. Utilization guidelines for each contract<\/strong><\/p>\n

10. The average turnaround time of each payer<\/strong><\/p>\n

11. Payment policies for services rendered by physician assistants<\/strong><\/p>\n

12. The exclusions and inclusions of payable services<\/strong><\/p>\n

13. The claim appealing process\/window of insurers<\/strong><\/p>\n<\/div><\/div>[vc_empty_space height=”20px”]

Handpicked!\u00a0<\/strong>Payer Group AR Assessment Tool<\/h4>\n<\/div><\/div>[vc_empty_space height=”20px”][vc_btn title=”AR Assessment Tool” color=”warning” link=”url:https%3A%2F%2Fwww.billingparadise.com%2Frcm-tools%2Fmgma-ar-benchmark-calculator%2Fpayer-group.html%3Futm_source%3DBP_blog%26utm_medium%3Dpayergr%26utm_campaign%3DGet_Free_Access|||”]


\nThe next step:<\/strong>
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Accurate data is just the means to an end. A majority of medical practices fail to leverage data collected, into meaningful and productive measures. Once you put together your payer matrix it is essential that you analyze the information at hand and take firm steps towards bettering your revenue cycle.<\/p>\n