Author Topic: Negotiating contracts  (Read 1867 times)

midwifebiller

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Negotiating contracts
« on: June 07, 2010, 12:46:27 PM »
We just welcomed our largest client yet and the best part is--they are contracted with all of the major payers.  (95% of our clients are OON , so this will be a  bit different for us.)  They were told by their previous biller that their contracted rates are too low and that they should renegotiate the contracts.

I am ready to learn how to negotiate fees.  I am very familiar with the midwife model of care and have spoken to many Provider Service reps and Medical Directors regarding equitable reimbursement rates for midwives, but it has always been in general OON terms, not with a contract. Where do I go to learn the nitties and gritties of negotiation?

Thanks!

~Kelli
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

PMRNC

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Re: Negotiating contracts
« Reply #1 on: June 07, 2010, 02:38:34 PM »
1st make sure the practice has an attorney, if they don't you could private contract with one. You do NOT want to negotiate contracts/fees without an experienced contract attorney unless you have done this for a while.

2nd, find a course to take if you don't have time to self - study and learn.  I have done credentialing for years before I ventured into contract and fee schedule's negotiations, I also took college courses in contract law and obtained my paralegal. There are even small things you pick up such as what to do if the carrier tells you they don't negotiate (many will tell you that), just from experience doing it. There are also formula's and data gathering you will need to do and very strict guidelines about discussing fees with other providers. (some will try to do this to see if they can get same rate and it puts both providers at risk)

It's really not as easy as just jumping into it, What I did when I started was I stuck with the carrier negotiations and then let the attorney sign off and review..If I used MY attorney they would bill the client and I would bill for my work, the lawyer just becomes a private contract.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

midwifebiller

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Re: Negotiating contracts
« Reply #2 on: June 07, 2010, 03:42:28 PM »
Thanks, Linda.

I have a good contract attorney and they have their own attorney, too.  We have a local community college and I will check the classes they offer on legal matters, especially contract law.  Is there a course or two on insurance contract negotiation that you can recommend?
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

Pay_My_Claims

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Re: Negotiating contracts
« Reply #3 on: June 08, 2010, 11:51:22 AM »
i didn't know they had classes for that..........i have to see what they have close to me or online. i have done it before, but not frequently

blhoffman

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Re: Negotiating contracts
« Reply #4 on: June 09, 2010, 01:00:02 PM »
I found this article on medical contract neg. and thought it was very helpful and interesting.

http://www.acpinternist.org/archives/1999/06/troublespts.htm


Pay_My_Claims

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Re: Negotiating contracts
« Reply #5 on: June 09, 2010, 09:44:51 PM »
I found this article on medical contract neg. and thought it was very helpful and interesting.

http://www.acpinternist.org/archives/1999/06/troublespts.htm



My researcher!! Thanks!!

blhoffman

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Re: Negotiating contracts
« Reply #6 on: June 10, 2010, 09:40:03 AM »
Your Welcome ;D

I also found this Webinar that looks really helpful but unfortunately it has already ended.

So....I researched the presenter and found her personal website and sent an email. I asked when she would have another webinar in the future and she stated if she has enough people interested she could set one up at any time. I also told her about the forum and asked her if she would like to join. This is the link below to the Webinar I was speaking on.

http://managedcareinstitute.com/index.php?option=com_content&view=article&id=4:negotiation&catid=13:webinars&Itemid=12

This is her email - Maria Todd [maria@mariatodd.com]

Pay_My_Claims

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Re: Negotiating contracts
« Reply #7 on: June 10, 2010, 01:40:07 PM »
cool, thanks