Negotiating With Managed Care

May 1, 2009

Could you please tell me how to negotiate higher reimbursements from commercial payers?

Question: Could you please tell me how to negotiate higher reimbursements from commercial payers?

Answer: Basically, you need to understand what you have to offer - proven outcomes, loyalty of a core patient population (like the school, police or fire departments, or a university near you), or a service that patients might otherwise have to travel farther to obtain.

You also can negotiate not on fees, but on logistics - take backs, preauthorizations, etc.

Or, negotiate just on a core set of fees, those you use the most, and let the others slide.

Finally, you should know what all your payers reimburse, so you can plainly tell your lowest payers that they are paying below market rates. Many are happy to pay the going rate - if you know what it is.