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Contracting

Contracting

Payer contract

3 Considerations You Must Make Before Dropping a Payer

Every payer contract your practice signs is a legal document that should not be taken lightly if you’re thinking of terminating it. But you should have a plan in place in case you’re ever in a position where a particular contract simply isn’t tenable for the long term. Check these three considerations every practice should […]
Contract negotiation

3 Payer Contract Negotiation Pitfalls Every Practice Must Avoid

Participating in a managed care contract negotiation cycle can often help your practice create more favorable terms and allow you to increase reimbursement and decrease administrative burden. While it may be a stressful time, it’s also an opportunity to improve unfavorable contract terms that you’ve dealt with for too long. What’s important is to take […]
Managed care contracting

8 Managed Care Contracting Tips to Solidify the Terms You Need

Managed care contracting can strike fear in the hearts of even the most seasoned medical practice manager. One bad contract term can haunt you for years, particularly when it affects the income you’re bringing in. Your best bet is to do some legwork before you sit down at the negotiating table. Check these eight managed […]
Contract negotiations

How to Respond When Payers Say ‘No’ in Contract Negotiations

Handling payer contract negotiations is never simple, and one area that many practices find particularly stressful is how to respond when a payer immediately says “no” to the terms you’re interested in pursuing. Although it can be off-putting to deal with an insurer who doesn’t want to work within your required terms, there are ways […]
Insurance contract

How to Leverage Your Strengths During Payer Negotiations

Once you’ve scheduled an insurance contract negotiation meeting with payers, you can’t simply breeze into the room without significant preparation. The best way to have the payer accept your terms is to identify any and all leverage you can use in the contracting process, and that’s easier said than done. It requires research and due […]
Insurance contract

How to Time and Schedule Your Insurance Contract Negotiations

Handling health insurance contract negotiations can give any practice manager a headache. There’s so much to remember, including which terms to avoid, who your contact should be at the payer organization, which rates work best, and much more. Among the issues that many practices struggle with is how often to renegotiate with payer sources. Read […]
Insurance contract

How to Navigate Negotiations and Land a Great Payer Contract

It can be tempting to put off your managed care contract negotiation responsibilities because working with payers feels like a self-defeating task. After all, insurers are poised to say “no” to every negotiation technique you attempt, and you certainly don’t want to accept the first terms they offer. There are, however, ways to navigate those […]
Managed care contracts

Decipher Confusing Payer Contract Language & Get Paid More

If you’re among the medical practice staffers who groan when it’s time to review managed care contracts, that could be because you know payers bury confusing language into the documents. One step to understanding what these contracts say is to break down each section and look for key phrases that can help you reduce confusion […]
managed care contracts

Avoid Payer Contract Horrors: Know When to Call Your Attorney

Whether you’re negotiating managed care contracts for the first time in your career or you’re a seasoned pro, one thing is certain: you can’t afford to make a mistake. Reimbursement from managed care insurers is likely to make up the bulk of your practice’s income, so it’s critical that you understand exactly what language to […]
Appeal letter

Avoid These 6 Payor Appeal Letter Mistakes & Get Patients Back

Getting dropped by any of your payors is a nightmare, especially if it causes you to lose patients because you’re now out-of-network with their insurance. The first step toward getting reinstated with any payor is to write an appeal letter asking for reconsideration. But this letter must be carefully crafted in order to help you […]