decisionhealth Newsletters, Part B News - 2011 Issue 9 (September)
4 signs that you should renegotiate with private payers for higher rates
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Article Overview
This article discusses contract renegotiation in the context of private payers and focuses on practical indicators that a practice may need to review its reimbursement arrangements. It is aimed at physician practices, office managers, and contract or revenue cycle staff who evaluate payer relationships, compare payment levels, and consider whether current agreements still fit the practice’s costs and workload. The piece covers broad considerations such as benchmarking against peers, timing of negotiations, administrative burden, and changes in practice expenses or growth.
Why This Topic Matters
Private payer contracts can materially affect practice revenue, so knowing when to revisit them helps organizations identify underpayment risk and decide whether to invest time in negotiations.
Article Sections
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Contract negotiations
Introduces the topic of payer contract negotiation and explains that practices should evaluate whether they have a basis and the resources to pursue renegotiation.
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Here are four signs that your contract should be renegotiated:
Presents the main indicators discussed in the article for when a practice may want to review its private payer agreements and compare contract performance.
What You Will Learn
- How practices can think about whether a private payer contract should be reviewed
- What general factors may indicate a need to revisit reimbursement arrangements
- Why benchmarking and administrative burden matter in contract assessment
- How practice growth or cost changes can affect the need for renegotiation
Who Should Read This
- Physician practices
- Practice administrators
- Revenue cycle staff
- Contracting specialists
- Medical group managers
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