Negotiating managed care contracts may make you feel like you’re talking to a brick wall.
Unfortunately, insurers want you to feel that way, because if they stonewall you, the odds that you’ll simply sign whichever documents they put in front of you increase exponentially. Your best bet for negotiating contract terms that will work in your favor is to recognize and eliminate damaging clauses while adding terminology that will increase your practice’s reimbursement and improve your payment terms.
During this 3-Part online training series, three healthcare contract experts will show you exactly how to come out ahead when negotiating your next managed care contracts — and renegotiating existing ones.
Don’t wait — register today for this three-part series so you can benefit from these insider contract negotiation strategies and start bringing in more cash.
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Order your 3-Part series in the next 5 days, and you’ll save an additional 15% off the total cost. Discount is already reflected. No code necessary. Or, if you prefer, you can order each session individually at the regular rate. ORDER TODAY!
PART 1: Negotiate Higher-Paying Third-Party Payer Contracts
Attend the live session on Wednesday, November 6th at 1:00pm ET OR,
Available Immediately, Order the On-Demand Recording to Watch at Your Convenience.
Third-party payers don’t want you to know the truth. They don’t want you to know that you CAN get paid more and that it’s easier than you might think.
Payers have one goal in mind – to pay you less. They do this by making the contract negotiation process as confusing as possible (i.e., outdated fee schedules, confusing contract language, etc.).
The more challenging it is for you to negotiate your third-party payer contracts, the more likely you are to give up. In fact, this is precisely what they are counting on. However, if you know how, you can get payers to cough up the extra reimbursement you deserve.
There are ways to break through the payer contracting wall. You can get them to respond to your requests and, yes, increase your rates if you know how to get them to work with you and kick-start discussions.
This is where third-party payer contract negotiation expert Doral Jacobsen MBA, FACMPE, comes in. On Wednesday, November 6th at 1 pm ET, Doral will walk you through how to build and deploy a successful payer contracting strategy step-by-step. You’ll get proven communication scripts, and you’ll even receive a guide to develop your practice’s own value proposition. Armed with these tools, you’ll be able to engage payers and secure increased rates much more quickly and easily.
Here are just some of the proven third-party payer contract negotiation tactics you’ll be able to utilize after attending this expert-led online training:
- Create and implement your practice’s negotiation strategy
- Proven verbiage that helps you tell your practice’s story and speed negotiations
- Complete a market and provider assessment that shows payers why you deserve more money
- Establish a third-party payer proposal process to effectively evaluate offers
- Pinpoint the exact questions you must ask during early payer discussions
- Identify the precise steps you must take to create your practice’s unique value proposition
- Tried ‘n’ true templates that accelerate your work and get results
- Tips to convince payers to pay you based on the value your practice provides to the network
- More easily navigate the negotiation process
- How to speak the payers’ language, so you win the terms you need to succeed
- Learn how to quantify the value your practice adds
- Get your negotiation requests approved using proven post-denial request timeframes
- Determine how to incorporate administrative burden discussions into your negotiations
- Secure higher rates with tips to write results-clinching payer proposals
- Methods that remove harmful clauses like penalties for non-network providers
- Define why you outshine the competition to clinch better coverage
- And so much more…
PART 2: Managed Care Contracts: Proven Language to Get Paid More
Available Immediately, Order the On-Demand Recording to Watch at Your Convenience.
You have more control over the terms of your managed care contracts than you realize (including how much reimbursement you receive).
Managed Care Contract Language
It doesn’t matter if you’re negotiating with a payer for the first time, or trying to modify an existing agreement, it all comes down to the same thing – the language in your contract. Remember, your managed care contracts are written with the best interest of the payer in mind. So, unless you know what language to look for, deciphering the pages and pages of legalese can seem impossible.
Sometimes one simple change to the language in your managed care contracts can significantly increase your patient referrals and reimbursement, but you have to know what changed.
Maximize Managed Care Contract Terms
This is where healthcare attorney Michael R. Lowe, Esq., can help. During his 60-minute online training, he’ll provide you with valuable takeaways and a step-by-step process so you can quickly evaluate your payer contracts, identify hidden opportunities, and negotiate to maximize your reimbursements.
By attending this 60-minute online training, you’ll learn a myriad of tips about negotiating your managed care contracts, including how to:
- Write a market and provider assessment that shows payers why you deserve more money
- Pinpoint the exact questions you must ask during early payer discussions
- How to speak the payers’ language so you win the terms you need to succeed
- Understand and eliminate unilateral amendment provisions
- Take control of reimbursement language to get paid more
- Optimize counter offers with proven evaluation strategies
- Compare your payer contracts and use the results to negotiate better rates
- Uncover silent PPO provision contract language that can hurt your practice
- Draft a more powerful proposal letter to give you a negotiation advantage
- Make sure your contract includes all necessary schedules and exhibits
- Address covered and non‐covered services provisions for maximum clarity and protection
- Determine how to incorporate administrative burden discussions into your negotiations
- Identify hidden opportunities and threats in your contracts
- Remove harmful clauses like penalties for non‐network providers
- And so much more …
PART 3: Get Higher-Paying Contracts with Proven Negotiation Strategies
Available Immediately. Order the On-Demand Recording to Watch at Your Convenience.
Don’t give up on your under-reimbursing managed care contracts due to a lack of payer response to your negotiation requests. This is actually what they want you to do.
Payers are notorious for ignoring contract negotiation requests. However, it is possible to gain leverage to get them to update expired fee schedules and even change confusing termination language in your contract. But you must get their attention first. To do this, you must know how to speak “payer.” Once you do, you can get them to respond to your negotiation requests and even increase your rates.
This is where payer contract negotiation expert David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, comes in. David will show you how to build and deploy a successful payer contracting strategy. Armed with this step-by-step plan of attack, you’ll engage payers more quickly and easily in contract negotiations and improve your results.
Here are just some of the proven payer contract negotiation tactics you’ll learn when you attend this 60-minute online training:
- Avoid the mistake of negotiating new and existing contracts the same way
- Create a successful negotiation strategy with easy-to-implement steps
- Write a unique value proposition that makes your practice stand out
- Ease the negotiation process by communicating what payers REALLY want
- Get proven questions to ask early in payer discussions to improve outcomes
- Uncover your practice’s most useful value proposition and use it
- Communication tactics to improve contract renegotiation results
- Steps to utilize your existing contracts and fee schedules to your benefit
- Pin down your practices unique value proposition and get it heard
- Communicate using payer language to get the contract terms you want
- And so much more…
Past Webinar Reviews:
“The speaker is incredibly informative and made the presentation engaging for individuals without previous experience in this area.”
– Aubree Coats, Pediatric Home Healthcare, LLC
“Great! The handouts were outlined very well.”
– Beth Clardy, Practice Manager and Co-Founder, The Chadwick Clinic
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Doral Davis-Jacobsen, MBA, FACMPE, is a Partner at Prosper Beyond LLC, a specialized healthcare consulting firm nestled in beautiful Asheville, North Carolina. Doral is a seasoned healthcare consultant with over 20 years of experience serving healthcare providers ranging from solo practitioners to large academic medical centers. She is a popular speaker and author, always looking around the corner to help her clients prepare for “what’s next.” Doral is known for assisting practices with next generation managed care contract negotiations, payment reform and revenue cycle.
She is a Fellow in the American College of Medical Practice Executives. Doral serves as the Chair for the North Carolina MGMA Payer Contracting Committee 2019. Doral has written numerous articles on medical practice revenue cycle, managed care contracting and payment reform and is a frequent speaker at national, regional and local healthcare forums. Doral is a co-author of MGMA’s book, Transitioning to Alternative Payment Models: A Guide to Next Generation Managed Care Contracting, published in October 2016.
Michael is board certified in health care law by The Florida Bar. As Managing Partner of Lowe & Evander, P.A., his practice focuses on all aspects of business, corporate, transactional, litigation, regulatory, operational, and administrative matters in the health care law arena.
Emphasizing the representation of physicians and physician group practices, Michael regularly represents clients in litigation, medical records, and HIPAA privacy regulations issues, managed care contracting and reimbursement matters, the preparation, review, and negotiation of physician employment agreements, Medicare/Medicaid fraud and abuse prevention, federal Stark Law matters and analysis, defense and reimbursement issues, ACA matters, medical staff privilege cases, professional licensure and disciplinary actions, voluntary self-disclosure cases, physician-hospital contracts, compliance plan development, and health care regulatory analysis and counseling matters.
Michael’s practice areas also include the representation of hospital medical staff, IPAs, ambulatory surgery centers, durable medical equipment providers, diagnostic imaging centers, hospitals, long-term care facilities, and other health care professionals and providers.
David Zetter is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 30 years of operational and healthcare experience.
Many recognize David nationally for his presentations and expertise. He excels in revenue cycle management, credentialing and contracting, compliance, coding and documentation. People see David as an expert on Medicare, not only by his clients, but his consultant colleagues across the country. He has evaluated existing ambulatory care facilities and practices with respect to patient flow, operations, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. David Zetter’s activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types. This includes coding and broad‐based regulatory issues. David has also conducted chart audits on behalf of Medicare contractors and Blue Cross/Blue Shield early in his career. This gave David the knowledge of what the expectations are from the payers.
David’s firm works with healthcare professional clients and facilities coast to coast. Zetter’s specialties include all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, and governance documentation. Zetter’s firm may also assist you in policies and procedures, credentialing and contracting, HR management, compliance, chart reviews, and more.
David has helped to maximize both profitability and reimbursement of physician practices, facility, and ambulatory practices. He also re‐engineered operational and human resources, addressing coding and billing issues for providers to curtail fraud, OIG, and IRS issues.
