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Payer Contract Negotiation Nuts and Bolts

Payer Contract Negotiation Nuts and Bolts

Contracts are long and complicated, often missing or obscuring key information a provider needs to make an informed decision about whether to agree to the contract’s terms. In addition, insurance companies are incredibly resistant to modifying their contracts. Contract negotiation employees often say “no” to even minor changes, expecting that the provider will back down. It takes a significant amount of pushing back to gain access to the staff with the power to make changes. Many providers, we know, simply negotiate the fee schedule, and sign the payer contract without a full understanding of its content. We think that is a mistake—these contracts can have legal and financial impacts unrelated to the fee schedule rates, which outlive the contract itself. But, it's not always clear what parts of these gargantuan documents medical practices should be looking for to reduce their risk. In this post, we describe specific types of provisions to read carefully and consider, how easy it will be to change them, and why you may be agreeing to more than the language inside the contract:     

Buying Professional Liability (Malpractice) Insurance

Buying Professional Liability (Malpractice) Insurance

One of the key elements of any healthcare provider’s risk management plan is securing professional liability (also known as “medical malpractice”) insurance coverage. But, all professional liability policies are not created equal. When considering which policy to purchase, physicians and other healthcare providers should thoroughly examine and understand who the policy covers, how coverage is triggered, and the types of patient claims that are eligible for coverage. . . .