Help CenterFollow our step-by-step process to prepare your data to build a data-driven business case for your next rate negotiation.
Overview
When you first open the file you will see a list of steps for updating the file using your data.
As a general rule worksheets with an orange color should not be edited and some are password protected to ensure the formulas are correct. The green worksheets have one or more columns that should be replaced with your own data.
As you navigate through the file you will find some prepopulated formulas that perform helpful calculations and is best if you leave them unedited. Formula columns will be orange if they shouldn't be edited so they are easy to spot.
Step 1
Replace the sample data values in the Codes & Volumes worksheet with the codes, modifiers, volumes, and rates your practice has billed for the previous calendar year based on data from your internal systems.
If a code doesn't have a billing code modifier, use N/A to reference its global rate. Other modifiers are usually enclosed in brackets as shown in the sample data.
Step 2
Sort your data in the Codes & Volumes worksheet alphabetically by Code (the first column) and then by Modifier (the second column).
Step 3
Download data from the HexIQ Negotiated Rate platform for the codes you identified in Step 1 for your state (or optionally use a tighter radius around your practice's address). Make sure you've only chosen 1 payer, 1 specialty, and 1 place of service in your filter criteria.
Step 4
Clear any sample data in the Raw Data worksheet for columns B onward (leaving only the formulas contained in Column A).
Step 5
Copy all of the columns and rows in the CSV you downloaded in step 3, and paste it into the Raw Data worksheet with your cursor in cell B1 (this ensures that column A stays untouched and keeps the formula required for this template to work).
Step 6
Make sure the Billing Code Modifiers you've entered on the Codes & Volumes worksheet are formatted to match the values as they appear on the Raw Data worksheet so that all of the lookups will work properly.
Step 7
Analyze the data and find the Tax Identification Numbers (TINs) that have published rates associated with your practice. Paste them into the appropriate column in the TINs worksheet.
Step 8
Analyze the data and find the TINs that have published rates associated with any competitive practices in your market. Paste them into the appropriate column in the TINs worksheet.
Step 9
Analyze the data and find the TINs that have published rates associated with any larger market players (espeically any that have been acquiring other practices similar to yours). Paste them into the appropriate column in the TINs worksheet.
Step 10
Look at the Rate Ranges by Code worksheet to see how your rates compare with others in your market.
Step 11
Look at the Summary Data tab to evaluate your most compelling fact for each code and model out your desired future state rates to calculate the projected impact on your bottom line.