reimbursement rates

[mike]

Is it possible to renegotiate reimbursement rates from different insurance companies? If so, is it addressed in the "Mental Health Billing Made Easy" book?
I already purchased the book for my wife, the psychologist, but I neither one of us have had time to get past the first few pages. I could not wait to have that question answered because there are a few insurance companies that are not reimbursing appropriately for services, but she does not want to discriminate based on the insurance someone has. Hope the question makes sense. Thanks for any help.

[DMK]

Is it possible to renegotiate reimbursement rates from different insurance companies? If so, is it addressed in the "Mental Health Billing Made Easy" book?
I already purchased the book for my wife, the psychologist, but I neither one of us have had time to get past the first few pages. I could not wait to have that question answered because there are a few insurance companies that are not reimbursing appropriately for services, but she does not want to discriminate based on the insurance someone has. Hope the question makes sense. Thanks for any help.

Welcome to the wonderful world of health care!  There will always be insurance companies who will reimburse significantly less than others.  Plan accordingly, but JMO discriminating based on insurance isn't fair or kind.  I believe Alice, Michele, and Linda have all mentioned that you can negotiate with insurance companies.

[mike]

Thanks for the quick reply.
Yes, I agree that discriminating based on insurance isn't kind or even ethical. That is why I ask.

I would now like to know what JMO means. 

[rdmoore2003]

Is it possible to renegotiate reimbursement rates from different insurance companies?



Yes it is possible to negotiate reimbursement rates.   If you already have a contract with an insurance company, you will have to wait until the contract expires and when/if you decide to "reup" the contract, that is when you will negotiate.

[PMRNC]

I do full credentialing and fee-schedule negotiating goes along with it. I usually require the practice have an attorney to sign off and give final thumbs up on the contracts and fee-schedule but I do all the leg work. Sometimes it works and sometimes it doesn't.  I've run into situations where carriers will not even negotiate with you unless you sign a non-disclosure (meaning you won't talk about it with other providers..big no no)   It's definitely not a service i would perform unless you have extensive experience with codes, fee schedules and more important, managed care contracts. Carriers do try to slip things in there and if you don't catch it you leave your client in a bad spot. For example a carrier tried to sneak in that if we left the contract we would have to give 6 months notice!  LOL  No way in hell. Those contracts are very long and tedious.

[Michele]

JMO  = just my opinion

We do not cover fee negotiation in the mental health billing book.  As Linda said it can be a long, tedious process.  But the answer to your question is yes, you can contact the insurance carriers and negotiate fees.  The problem is if your wife is already in network and has already signed contracts with the insurance carriers it may be too late.  Or she may have to be willing to say she is going to leave the network if new fees are not negotiated, and then be willing to follow thru.  Of course she would have to follow the contract on opting out if that's what she decides to do.

Good luck!