One of the sad facts about the healthcare industry is that there tends to be a very one-sided relationship between insurance companies and service providers. Insurance companies change their requirements and payment structures on a regular basis, but medical professionals rarely take the time to worry about their payer contracts. As medical practice management professionals, we understand the importance of payer contracts and we also understand that payer contracts need constant attention to be effective.

Negotiations Start Before You Sign The Contract

Whenever we talk to new clients, it is surprising to us to find out how many medical practices signed their payer contracts without even negotiating their rates. One of the biggest misconceptions in the healthcare industry is that a medical practice cannot negotiate a payer agreement with an insurance company or any other kind of payer. This is absolutely not true and we can help you get your payer relationship off to the right start with fair negotiations.
We will act as your administrative arm and negotiate your new payer contracts in a way that gets the most for your practice. Our experienced professionals know how to work with insurance companies to make certain that you are compensated fairly for the services you provide.

Never Be Afraid To Renegotiate

While we are usually surprised at how many medical professionals do not negotiate their new payer contracts prior to signing them, we are not surprised to find out that almost none of our clients try to renegotiate their rates when it comes time to renew their payer agreements.

Insurance companies do not like resistance, which is why your health insurance partners would prefer that you just renewed your contract without asking for any changes outside of the changes the insurance company has put forth. But the renewal period on your payer contract is the very best time for you to discuss a rate increase based on your increased costs.
We will put together a professional evaluation of the increase in your costs for doing business and then use that as the foundation for renegotiating your payer rates. As a practice management firm, it is our job to make sure that you are compensated properly for your professional services. When it comes time to renew your payer agreements, we take that as an opportunity to make sure that your rates are updated to reflect your rising costs.

Do Not Leave Money On The Table

Whenever you sign any kind of payer contract without negotiating for better terms, you are leaving money on the table. The notion that insurance companies will not negotiate is incorrect and also damaging to your business. Most medical professionals are uncomfortable negotiating their payer rates, which is why they hire us to do the negotations for them.
When your practice signs up with a payer for the first time, you are establishing a financial relationship that will help determine the success or failure of your practice. If you want to get the most financial benefit out of that relationship, then you need to let the payer know that you have certain expectations for compensation that must be considered when the rates are established. Our professionals will make sure that your side of the story is heard and that your payer rates are always fair and reasonable.