BC Advantage - 2015 Issue 10
How practices can negotiate higher reimbursement rates
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Article Overview
This article discusses how medical practices can evaluate and negotiate reimbursement rates with insurance payers. It focuses on the business side of payer contracting, including how practices can present value to a network, document cost savings, and support negotiations with data and analysis. The piece is aimed at physicians, practice managers, and healthcare consultants who want to understand broad contract negotiation strategy and why it can affect practice profitability.
Why This Topic Matters
Reimbursement rates can materially affect whether a practice is profitable, and many small or independent practices may not realize they can revisit existing payer contracts. Understanding the general negotiation approach described here can help readers assess whether the article is relevant to their contracting and revenue strategy needs.
What You Will Learn
- How reimbursement rates affect practice financial performance
- Why payer contracting is a strategic business issue for practices
- What kinds of value a practice may present during contract discussions
- How data and analysis can support payer negotiations
- Why outside consulting support may be useful in reimbursement discussions
Who Should Read This
- Physicians
- Practice administrators
- Medical group managers
- Healthcare consultants
- Revenue cycle professionals
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