Medical Billing Forum

General Category => General Questions => Topic started by: isabelreyna on October 27, 2014, 05:49:28 PM

Title: negotiating prices for your provider
Post by: isabelreyna on October 27, 2014, 05:49:28 PM
Does somebody have experience negotiating prices for your provider with the payers and if so where do I learn to do that. I have a potential client..... :D
Title: Re: negotiating prices for your provider
Post by: PMRNC on October 29, 2014, 05:56:40 AM
I have done this but it's a part of full credentialing. It involves a lot of research and review of all contracts (old/current) and obtaining data for each geographical area. You also want to make sure the practice has an attorney on hand to review and/or negotiate the contracts with the negotiations. Many times it is not JUST the fees that need negotiating.
Title: Re: negotiating prices for your provider
Post by: isabelreyna on October 29, 2014, 10:19:17 AM
A provider call me, she told me she just starting out. I would like to learn how to do negotiating since I don't want to say no to a provider or I will not get any business. Where did you learn how to research or where to go? this is my e-mail isabelreyna1962@wowway.com if you have time?
Title: Re: negotiating prices for your provider
Post by: PMRNC on October 29, 2014, 02:35:21 PM
Quote
A provider call me, she told me she just starting out. I would like to learn how to do negotiating since I don't want to say no to a provider or I will not get any business. Where did you learn how to research or where to go? this is my e-mail isabelreyna1962@wowway.com if you have time?

I have no idea of your experience so it's hard to answer this.. I can't SAY this is a "LEARNED" service but rather one that comes from experience with credentialing and of course knowing medical billing. I also NEVER do this tier of credentialing unless the client is going to have an attorney sign off on all negotiations of both fee schedule and contract. This really isn't a service you can "learn" it comes from experience.. years really. Saying no to a provider might be a better option than saying yes and screwing things up.. this is a VITAL piece of credentialing and you don't want to go into it not knowing what your doing.
Title: Re: negotiating prices for your provider
Post by: kristin on October 29, 2014, 04:30:41 PM
Agree with Linda, credentialing/fee negotiation/contracting is not easy, and I have seen what happens when someone tries to do it for a provider when they have no experience with it. The end result was not pretty, to say the least. The biller lost the client half-way through the process because so many mistakes happened.

It is something I would have an experienced credentialer or healthcare attorney handle. While I understand wanting to sign a client, the client has to understand that some things can't be handled by you at this point, and are best done by someone who specializes in it.
Title: Re: negotiating prices for your provider
Post by: PMRNC on October 30, 2014, 03:29:40 PM
This is just one area you cannot "LEARN", it's based on experience.. many years of it.
Title: Re: negotiating prices for your provider
Post by: isabelreyna on October 31, 2014, 08:05:20 PM
how can someone just experience it. Some time some one had to learn it.. Credentialing can't be mad science everything has to be learn by somebody who is not afraid of trying.  I just need to find somebody to teach it to me. Even before I can take on a client. I am not afraid to learn anything...but thank you all for you help....
Title: Re: negotiating prices for your provider
Post by: Merry on October 31, 2014, 09:54:31 PM
I don't think anyone was thinking you couldnt do it. It really is not something that you can learn that easily or from a book. I can't imagine anyone doing this without years of experience. Just my opinion.