In-Kind Payments

In-kind benefits are the valuable considerations which are negotiated between health insurors and providers as partial payment for giving a reduction in retail charges.  In-kind benefits are a form of payment which, when added to the cash payment(s) made by an insurer equals 100% of retail charges and establishes the value of the medical care.

 

IN-KIND (NON-CASH) CONTRACTUAL BENEFITS TO A
MEDICAL PROVIDER WITHIN A PAYOR-PROVIDER AGREEMENT.  
Source:  Lawrence “Lan” Lievense, FHFMA, FACMPE

  1. advertising programs assistance
  2. marketing programs assistance
  3. listing in health provider sources
  4. rapid claims payment guarantees
  5. bonus payment programs based on patient volume levels
  6. non-compete agreements (exclusive provider agreement)
  7. enhanced eligibility and benefits verification capabilities
  8. staff training by payor teams
  9. online contract access
  10. retrospective claims audit (vs concurrent or pre-payment)
  11. support and participation in provider health fairs, community activities
  12. advance notice of changes in provider manuals
  13. changes in claims submission requirements
  14. changes in benefits and eligibility verification processes
  15. simplified contract renewal process
  16. provider/physician access to desirable training seminars and conventions
  17. reduced pricing for providers attending payor seminars, conventions
  18. assist provider with hiring/recruitment of physicians, clinicians, administrators
  19. more frequent visits by payor representatives
  20. regularly scheduled visits by payor representatives
  21. accelerated process of denied claims resubmission & resolution
  22. accelerated appeals process for denied/delayed treatment authorizations
  23. accelerated appeals process for denied claims
  24. enhanced (increased) detail on remittance advices
  25. enhanced (increased) detail on explanation of benefits
  26. enhanced (increased) detail on authorization notices
  27. inclusion of providers’ direct collections line on beneficiary notices
  28. dedicated staffing at payor for provider (authorization, eligibility, claims, appeals)
  29. higher payment allowances for carve-out items
  30. stop-loss agreements for high balance patient accounts
  31. accelerated reporting to providers (IBNR, monthly/quarterly statuses…)
  32. listing of provider on payor web site – with patients directed to providers geo area
  33. electronic eligibility
  34. electronic claims submission
  35. electronic EOB’s
  36. electronic denials
  37. electronic resubmissions of claims
  38. electronic funds transfer
  39. fixed (predictable) cash payments w/simplified reconciliation