• Adam Kae & Associates

Negotiation for Physicians




We get it, you're a doctor, not a lawyer! So we understand if you dread the idea of negotiating with your insurance company.


Negotiation may not be your cup of tea, but it can impact you AND your clients. Think: more money in your pocket, saving your patients money, and getting paid in record time.

It's more than a big smile and a "salesman" technique or two. To negotiate for the best rate, you'll need to create a comprehensive negotiation strategy.

Your Negotiation Strategy


Models, Forecasts, Calculations, Oh My!


You'll need to do some math to understand:

  • where your breakeven is

  • how many of your patients are in-network

  • how much your rate should increase to profit more for your practice


Think about what your practice's goals are. Do you want to grow more? Pay off debt? Invest more in new technology?


The answers to those questions can determine your negotiation strategy.


Also, be sure to understand the demand in your area for your specialty. The higher the demand, the more your potential leveraging power!


Put together a packet of information on your generic financial documents. Then, it's best to do some modeling and forecast the different acceptable scenarios based on your negotiations.


Sounds like a lot of work? It's one of our specialty areas! Set up a call with us today and we can help!

What are you willing to leverage?


In the spirit of negotiations, there will likely be somewhere you'll have to compromise.


Calculate what kinds of fee schedules make the most sense. Take a close look at the most favored nation clauses (if applicable).


What are your payment provisions? What are the filing requirements on your end? If things come to the worst, are the termination conditions reasonable?


You can negotiate most parts of your contract. The secret? Most people choose not to!

Being in the Room

You're in the room in your best blazer. What happens now?

Your negotiation begins the moment you enter the door. Your body language, ability to listen, and your willingness to discuss will be an imminent part of the process.


It's a good thing to know too much here. Have your models ready, and be willing to answer any questions thrown your way. It's 100% okay if you don't know every answer! Keep a running list of those questions for later correspondence.


Keep your goals in mind, but also keep the other party's goals in mind! By understanding what they're after, you'll be more likely to find a willing compromise.


Don't look at challenging questions/"no's" as a conflict. But rather, it's an opportunity for further discussion.

Sound like a lot of work? We like being in the room where it happens, and we can manage your negotiations on your behalf if you'd like!

Final Thoughts...

Negotiations aren't easy, but they're a vital part of ensuring you're getting the most money from your hard work.


We're happy to help in all aspects of the process. Need a model? We've got you! Want to figure out how much you should negotiate your rate? We can help! Want us in the room to make it happen? Yes!


Schedule a call with us today, and let's chat about negotiating your way to further success!

Resources

Negotiating a Contract With a Health Plan -- FPM

How to Negotiate Higher Physician Reimbursement Rates

Negotiation tips for people who hate negotiating














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Disclaimer: This article contains information and opinions from Adam Kae & Associates, and the information and opinions should not necessarily be seen as the best possible solutions for your business. Please contact us at info@adamkae.com to help you find the best solutions for your business.