Payer contract negotiation is one of the few ways a practice can raise revenue without seeing another patient, yet most providers never learn how to do it. They spend years on clinical training and almost no time on the contracts that set what they get paid. That gap can cost a practice tens of thousands […]
Contract Negotiation, Payer Contract Analysis, Payer Contract Re-Negotiation, Payer Contracts, Rate Negotiation Service
Payer contracting takes two to six months for most practices, and how long it takes for you depends mostly on which payer sits on the other side of the application. Medicare enrollment through PECOS usually wraps up in two to three months because there are no rates to negotiate. Large commercial carriers like Aetna, Cigna, […]
Contract Negotiation, Contracting Process, Payer Contract Management, Payer Contracting Delays
Key Takeaways Healthcare providers run into the same wall over and over when negotiating and managing contracts with insurance companies. Solo physicians and massive hospital networks both feel it, just at different scales. The friction comes from a few consistent sources: unequal bargaining power, hidden rate data, mountains of paperwork, and a fragmented insurance market […]
Contract Negotiation, Practice Management, Provider Credentialing, Reimbursement Rates, Revenue Cycle Management
Parity laws were supposed to fix this, and in a lot of ways they did move things forward. On paper, mental health and substance use coverage has to match medical and surgical coverage dollar for dollar. In practice, behavioral health providers still see lower reimbursement rates than other specialties for work that takes just as […]
Behavioral Health Payer Contracting, Contract Negotiation, Fee Schedule Negotiation, Fee-for-Service, MHPAEA, Value-Based Care Models
Few areas of healthcare administration carry as much financial weight, and as much confusion, as payer contracting. It determines what a provider gets paid for the care they deliver, which patients can afford to see them, and how much administrative friction a practice deals with every time a claim goes out the door. Yet many […]
Contract Negotiation, Contract Renegotiation, Contract Restructuring, Fee Schedule, Rate Negotiation, Reimbursement Rates