Payer Contract Renegotiations
Most offices have never renegotiated their contracts and very few renegotiate them on an annual basis, missing out on additional revenue that can be substantial and greatly impact the practice’s revenue.
With your CodeToolz Contract Analyzer, your Contract Renegotiation Notices are automatically created for you, based on anniversary date – no more outdated fee schedules.
Payer Contract Renegotiation Timeline
Defining Your Payer Contracting Leverage
To identify your negotiation leverage (or lack thereof) and opportunities for shared benefit, start with a SWOT analysis (strengths, weaknesses, opportunities, threats). Most physicians come to the negotiation table without a defined contract strategy.
- Do you perform unique procedures or services, are you highly trained, is there a shortage in your market, etc.?
- What are benefits to the patients you treat; in your opinion, what is the level of patient satisfaction?
- What do you do clinically that reduces healthcare costs for the payer?
Successful Payer Contracting Renegotiations
If true, emphasize the fact that there has not been an increase in years.
Negotiating or renegotiating a payer contract for your medical practice can be one of the most important steps you can make toward improving the practice’s financial health.
Successful renegotiation of your payer contracts has a usual yield of 10 percent.
Payer Contracting (Prenegotiations)
Before you begin the negotiation process, you must decide on the important issues that you want to negotiate. There are two main issues involved with any managed care contract negotiation:
- Negotiation of financial terms, and
- Negotiation of legal terms.
To most providers, the most important part of any contract is the fee schedule. If the fee schedule is unacceptable, the clauses and language contained in the rest of the contract is irrelevant.
Payer Contracting (In Summary)
Ensuring maximum reimbursement in a timely manner is always at the top of a healthcare provider’s mind. But we find too often that many providers are leaving money on the table with inefficient and infrequent payer contract management.
For a more in-depth look, view: Payer Contracting in An Era of Declining Physician Reimbursements and Managing Your Payer Contracts Like a Pro.