1. A Presentation For The CDC Billing All-Projects Webinar Negotiating Reimbursement Rates With Third Party Payers 3/24/2015

2. Six Steps To Negotiating Reimbursement Rates 2 Vaccines Clinic Services Assess Costs Fee Analyzer Federal, State and Local Compliance Review/Update Fee Schedule Prioritize Fee Schedule Know The Payers

3. Six Steps To Negotiating Reimbursement Rates 3 Think Like a Payer Clinical Services Provider Profile Develop Leverage Develop Relations Tracking Tools Persistence Contact Payers Determine Timelines Renegotiate

4. Assess Costs 4 Purchased Vaccines – Administrative Functions Involved Administration of Vaccines Clinic Services if Appropriate

5. Review/Update Fee Schedule 5 Federal, State and Local Rules – Ensure Compliance Fee Analyzer – Customized to Local Area – National Medicare Fee Schedule

6. Know The Payers 6 Prioritize Fee Schedule – Usual and Customary Rates – Percentage of Medicare Fee Schedule Review The Landscape – Third Party Administrators – Managed Care Organizations – Preferred Provider Organizations

7. Develop Leverage 7 Think Like a Payer – Would You Be Familiar with Public Health Departments? Capture All Clinic Services Sell The “Why” Clinic and Provider Profile

8. Contact Payers 8 Develop Relationships – Customer Service Approach Tracking Tools – Database – File Folder Persistence – Overcome Barriers

9. Renegotiate Reimbursement Rates 9 Purchased Vaccines – Cost Fluctuation Clinic Services – Annual Review

10. Athina Kinsley Health Insurance Specialist akinsley@upp.com 10