Here is a recent post at The Independent Urologist with a discussion between a physician and an “expert on negotiating insurance contracts.”  While this post is specific to the New York market, there are a few key characteristics that would apply to practices throughout the country that are beginning to mull over the idea of calling their local payers to begin some sort of negotiation.

Here are some of the key elements as I interpreted them based on my conversation with the negotiator.

1. Unique: If you are the only one of your specialty in a 20 or so mile radius, you may have some leverage.
2. Efficient: If you can save the insurer money by operating at a lower cost to them, such as by doing in-office procedures, or with less errors due to an EMR, you may be able to make a case for the insurer to cut you a piece of the action in return.
3. Desirable: If you are one of few doctors who does something that people want or need and will pay more to the insurance company for it in the form of premiums or plan selection–then the insurer may cut you into the action as well.

And, here is the summary for those (the majority of us) that don’t have these characteristics:

Therefore, don’t feel like you are the only schmuck on the block that takes whatever contract is offered you. If you live and practice in an over saturated market and don’t have one of the big 3 characteristics in my list, you simply must sign on the line and work like a dog.

Tags: contracts, insurance panels, negotiation

This entry was posted on Tuesday, August 19th, 2008 at 4:46 pm and is filed under Insurance. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.