Payer Contracting and Payer Relations – Utilizing a reverse messenger model structure, WMI negotiates rates and contract language with each payer on behalf of its members. Each WMI member is then presented the agreement and via a ballot approach, decides whether to participate. Once the contract is established between the members and payer, WMI manages the relationship on behalf of the members facilitating issue resolution and disseminating pertinent information.
Contract Compliance – WMI works with the staff of each member group to monitor
the performance of each contracted payer to ensure compliance with the terms and intent of each
contract. When a compliance issue is found, WMI prompts and facilitates payer compliance.
Credentialing Assistance and Provider Set up – WMI provides credentialing
assistance to its members at both the physician and facility level. In most cases, WMI has
arranged expedited credentialing processes with the contracted payers, which WMI handles
completely on behalf of the members. WMI also works with the contracted payers to ensure
that the member facilities and physicians are set up correctly in the payers’ systems.
Practice Support/Revenue Cycle Tools, Training, and Expertise - WMI provides
practice support to include billing compliance, financial projections for pro forma, blinded
member surveys, etc. A large portion of practice support relates to the provision of revenue
cycle tools and training for member groups staff.
Joint Purchasing – WMI holds joint purchasing agreements and constantly explores
opportunities available to its membership via joint vendor contracts of any item or service a
radiology group needs to purchase. This contains costs for the groups, which then enhances WMI
members’ ability to negotiate payer contracts.
Recently, WMI contracted with The Advisory Board, a global research, technology and consulting firm.
This joint purchasing effort created significant membership fee savings and access to a leading organization
and their industry leading best practices."
Representation on Local and National Health Care Initiatives – WMI represents its
members on local and national health care initiatives as directed by its Board.