Contracting

Your CPT Data Could Be the Key to Higher Payer Reimbursement

When you ask a payer for a rate increase, are you asking for “more” — or can you show exactly where your reimbursement is falling short? That distinction matters. A general request for higher reimbursement gives the payer plenty of room to say no. A request supported by specific CPT codes, utilization, reimbursement comparisons and […]

Published Date: August 31, 2026

Is Your Payer Contract Quietly Costing Your Practice Money?

Paying more for staff, supplies, technology and virtually everything else required to run your medical practice? There is a good chance your expenses have increased substantially over the last several years. But have your payer reimbursement rates kept pace? If you haven’t reviewed and renegotiated your payer contracts recently, the answer may be no. And […]

Published Date: August 19, 2026

Medicaid Fraud Enforcement Is Getting More Aggressive — Here’s What You Need to Know

If you participates in Medicaid, Medicare, or managed care programs, your compliance risks are growing quickly. Federal agencies are dramatically increasing healthcare fraud enforcement efforts, and physician practices are now facing far more scrutiny around billing, eligibility verification, medical necessity, documentation accuracy, and reimbursement reporting. What used to be treated as a simple billing mistake […]

Published Date: June 2, 2026

How Your Medical Practice Really Gets Paid — And What You Can Do to Increase Reimbursement

If payer reimbursement feels confusing or unpredictable, you’re not alone. Many medical practices lose revenue every year—not because they’re providing the wrong care, but because they don’t fully understand how payers calculate payment or what levers they can control. Small misunderstandings in reimbursement methodology often lead to underpayments that go unnoticed for months or even […]

Published Date: February 4, 2026

Rank Your Insurance Payers to Evaluate Which Stay, Which Go

Your practice doesn’t necessarily need to expand your hours or bring in new patients to collect more income. In some cases, you may simply have to evaluate your insurance payers to determine which ones are paying you enough and which are causing you to lose money. One way to ensure you aren’t leaving money on […]

Published Date: August 6, 2025

Are Revenue Cycle Bottlenecks Costing Your Practice Thousands?

Dr. Lopez’s busy orthopedic practice submits hundreds of claims every week. But with denials creeping up, the billing team is constantly resubmitting claims. One front-desk employee, unfamiliar with payer rules, keeps entering incomplete patient insurance data—forcing staff to chase patients for missing information. Meanwhile, credentialing delays keep a new physician from being properly enrolled with […]

Published Date: July 24, 2025

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 […]

Published Date: December 30, 2024

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 […]

Published Date: November 26, 2024

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 […]

Published Date: August 10, 2024

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 […]

Published Date: November 14, 2023

Contracting

Contracting

Your CPT Data Could Be the Key to Higher Payer Reimbursement

Is Your Payer Contract Quietly Costing Your Practice Money?

Medicaid Fraud Enforcement Is Getting More Aggressive — Here’s What You Need to Know

How Your Medical Practice Really Gets Paid — And What You Can Do to Increase Reimbursement

Rank Your Insurance Payers to Evaluate Which Stay, Which Go

Are Revenue Cycle Bottlenecks Costing Your Practice Thousands?

3 Considerations You Must Make Before Dropping a Payer

3 Payer Contract Negotiation Pitfalls Every Practice Must Avoid

8 Managed Care Contracting Tips to Solidify the Terms You Need

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

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