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Payor contract negotiable?

March 22, 2016
Question:

Hi Jennifer, 

I am starting my own practice and was wondering, I see you say a lot that all contracts are negotiable...how about the payor contracts? They seem pretty uniform and I know my prior practice would just sign them. Should I be negotiating or hiring you to negotiate them?

Thanks, 
Dr. P

Answer: 

Good question!  Yes, I do believe all contracts are negotiable depending on your leverage...  Of course when a payor panel is almost or is full, you may not have much leverage, but for the most part, there is a bit of wiggle room.  When I review a payor contract I check for a few things - the most important to me are your ability to get out of the payor contract on reasonable notice (at any time), and to make sure the rates we believe we are entitled to under the contract can't be changed without notice.  I also look to make sure the audit process, which is always lurking nearby, is somewhat fair (can't always tell from the contract).  

Now, not everyone is going to be situated to get all of the above to "fair".  But, some payors have such draconian contracts you may be better off not signing in the first place.  So, what's the verdict?  Well, I recommend having payor contracts reviewed at the minimum, so you understand what you are signing. Whether or not you want to negotiate or have our office negotiate is a separate question that we can only answer after we review the proposed agreement.  Once we know what you have been offered - how bad are the terms?  Do you want to bother?  Do we believe we can be successful requesting change? We can decide whether or not to incur the expense to negotiate. 

Separate and apart from negotiation, on Thursday we will address the next question - which name do you sign in?  Practice or individual?
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