Preparing for Payer Negotiations: 7 Questions to Ask

Managed care contract negotiation is an ongoing process. Here are seven questions for healthcare providers to ask themselves when preparing to enter negotiations with a payer, according to a Medical Group Management Association report.

•    What percentage of patients and revenue is attributable to the payer?
•    What are the costs and margins by code/service for the payer?
•    What are days in accounts receivable for the payer like in comparison to other payers?
•    If competitors are in the payer's network, what are the competitors' strengths and weaknesses?
•    What grade did the payer receive from an internal payer report card?
•    What are the concessions you are willing to make to prevent termination of an agreement?

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