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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 […]
Payer contract negotiations

Administrative Burden: Ace Payer Negotiations, Get More Money

Payer contract negotiations get more frustrating every year. There’s the piles of paperwork, the back-and-forth, and the ultimate worry that one wrong move is going to cost your practice money. When you begin the negotiation process, it’s important to bring everything possible to the table to increase your chances that your final contract will be […]
Contract Negotiating Strategies

Boost Your Payments by 10% with Expert Contract Negotiating Strategies

It can be frustrating dealing with payers when you don’t have a track record of success, but you don’t have to accept the payer’s terms as they present them. You CAN get favorable rates. Knowing the right questions to ask and having a strategy to negotiate can lead to a healthier bottom line that your […]
Renegotiating Payer Contracts

6 Winning Contract Renegotiation Tactics

You can increase how much your third-party contracts pay. But it’s not easy. Insurers won’t help you to the money that’s just waiting on the table. And you may lack the confidence and experience to overcome their sneaky contract reimbursement reduction strategies. To renegotiate a payer contract that protects your practice’s profits, follow these tips: […]

Payer Negotiations: 5 Fee Schedule Prep Steps to Lock in Higher Rates

Preparation is key to any project or endeavor, and payer contract negotiations are no different. If you don’t have your ducks in a row including your fee schedule pricing demands and arguments, you could be shut down before you’re even out of the gate. The fee schedule portion of your payer contract outlines the rate […]

Watch Out for These 11 Devious Payer Contracting Negotiation Tricks

How hard are your managed care contracts working for you? Could payer contracting even be working against you? Payer reimbursements are the foundation of your practice revenue, but unfavorable contract terms can cost you thousands of dollars. Many providers find payer contract negotiation — or renegotiation — to be a complex and even uncomfortable task, […]

Tips for Getting Contracted into
Closed Payer Networks

Since many payer networks are already complete, it is often challenging for providers to get contracted. Therefore, the question is what can you do as a provider of valuable medical services to get into a closed or narrow payer network?