Insurance Contract Negotiations: Tips for Healthcare Professionals
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- Äas pĆidĂĄn 28. 08. 2024
- Are you a healthcare professional looking to navigate complex insurance contract negotiations? In this video, we dive into the ins and outs of negotiating insurance contracts, sharing valuable insights and strategies to help you succeed.
Join us as we discuss the importance of data and financial reports in supporting your negotiation efforts. Learn how to identify your lowest and highest-paying payers, understand your overhead costs, and determine the true cost of your services. Armed with this information, you can confidently approach contract negotiations.
Discover the foot-in-the-door approach to negotiation - if a payer initially declines renegotiation, find out how to propose increasing reimbursement for specific CPT codes. We'll also explore ways to showcase your value as a provider, emphasizing what sets you apart from others in your field.
Negotiating contracts can be challenging, but persistence and professionalism are key. Plus, we'll discuss the evolving landscape of healthcare reimbursement, including the shift toward value-based models.
If you're a healthcare professional with experience in payer negotiations or have valuable insights, please leave your comments below. Don't forget to like, subscribe, and share this video with your colleagues. We appreciate your support!
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Hi there! My name is Jennifer. Over the last 15 years, I've gained much experience working in the medical field in various roles. Through my experience, I've seen many medical practice owners make mistakes in running their businesses. That's why I created this channel - to help medical practice owners avoid these common pitfalls. I aim to promote growth and success within the private practice world of medicine. Healthcare has become too standardized, creating many unnecessary challenges and demands.
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Your candor, your relevance (especially as another biller in Oregon!), your approach... I am so grateful for your channel and how much you've shared via your channel and blog! Thank you for helping me feel less alone in the field and for providing such helpful nuggets in your videos. I've shared this one as well with our clinicians so they more clearly understand the process. THANK YOU!!! đđŻ
You are so welcome! Itâs viewers like you that help me keep up doing what Iâm doing!
This is very helpful! I have been struggling with insurance at times who don't really have that extra room for flexibility to negotiate especially as a new contractor. I have been managing an Outpatient Psych office and I also handle credentialing and contracts. Diving into contracts and what these payers offer to pay sometimes it's low but do to our specialty I feel we have the upper hand do so. The need for Mental Health is so HIGH right now. You are definitely helping with learning and understanding how to navigate this better. Thank you so much!!!
You are very welcome! Keep up the hard work because it will pay off! Thank you for watching!
Great tips, however, many insurance companies will send you an Amendment & inform you that you are now taking a particular plan. No Fee Schedule is sent. Then you are stuck because if you don't participate in ALL plans, then they often won't let you drop just one! Has anyone else had this issue?
This is very interesting and I have not heard of this until now. Unfortunately, it does not surprise me. It seems just when things seem to be going well and people are finally able to navigate a certain space or detail with insurance, they change it up again. Iâm sure it is also location and payer-specific. Remember, it is OK to advocate for yourself and ask for negotiations to see if there is any wiggle room and you can always ask for a fee schedule if you need one. Thank you for the information.
Thanks for the Video. I started contracting last year. The one thing I get is to keep on approaching the payer if they say they are willing to provide some raise. I have a question. If the contracting rep sometimes shuts you down and doesn't respond to your email. Is there a way to reach the supervisor? As I have very difficulty reaching out to Aetna's Contracting Rep.
Hi there and thank you for watching! Aetna, in my experience, has also been a challenging insurance to escalate issues. Iâve been known to call their claims department, or another department and ask for a supervisor. I have also asked to see if they have an alternative contact method or email address/phone number to try. I canât say Iâve always been successful but I do try other avenues to see if someone can help get me there. Iâm sorry youâre experiencing that, but youâre not alone. Good luck!
@@navigatingthebusinessofmed8251 ok. I will see what I can do. Actually, I have a successful negotiation on few of CPTs and the rep said that she was building the contract and now she is not responding. This was happening from last 3 months.
I hope I can get a response.
Thanks for your prompt response. Really appreciate your help.
Something is scratchy with the audio. I would recommend getting a new mic. Look into shotgun mics. Great videos, appreciate your work.
Thank you, I will look into those! I appreciate you watching.