Leading the Business of Healthcare
RCM Advisor

Quarter 2 2023 - Volume 28, ISSUE 2

Spotlight on the Commercial Payor Relations (CPR) Committee

Around the HBMA

By Ramesh Gogineni, CHBME, Chair

At the core of the HBMA is the CPR Committee. Most of our members interact with commercial insurance payors in our everyday business lives. Our communication with and understanding of the policies and guidelines of these payors is vital to our business interests.

The mission of the CPR committee is to promote this communication and understanding by serving as an “advocate for our membership and industry by establishing meaningful relationships with payors through cooperative initiatives that strive to reduce costs, administrative burdens and aid our membership in dealing with the increasing complexity of billing and reimbursement process.”

The members of the CPR Committee have established relationships with key contacts from our payors, which helps us become better informed, while also providing intangible value to our individual organizations. The committee members meet once a month for about an hour. Additionally, we meet quarterly with each sub-committee that we are part of, and quarterly with all the payors. We currently work with Aetna, Cigna, Humana, and United Healthcare, and we are working to add more payors.

We are pleased to have held our inaugural Payor Week from March 20 -24, 2023. We hope members of your team were able to attend at least some of the sessions in order to learn how to do business with each of the commercial payors. Some senior members from each of the payors participated as well. We had an agenda for each day so that your team members could attend and ask questions from our commercial payors. Payor Week was designed to be an invaluable educational tool, and we hope you were able to join to make it a success and learn from it.

We would appreciate your help in bringing more payors on board and adding fresh ideas on what the CPR committee can do for our members. If you are interested in volunteering for this committee, please feel free to email info@hbma.org or call me directly at (703) 831-4207. We look forward to hearing from you!