How to Negotiate Fee Increases with Insurance Companies?

The importance of physicians, hospitals, and other health care providers has never been recognized more than today when the whole world is fighting a war against COVID 19 pandemic. However, the medical fraternity still faces challenges in maintaining its financial stability. One such significant challenge is to receive fair compensation from the insurance.

Most physicians and other specialists participate in more than one insurance plan after completing several tedious and time-consuming procedural formalities. A seasoned medical billing services firm can help you get better rates.

How to Negotiate Fee Increases with Insurance Companies

Read on to find how you can negotiate with your insurance for an increase in reimbursement fees:

Step#1 Get thorough with your insurance contracts

Acquire complete knowledge about the existing contracts/agreements. Look for the current reimbursement rates and see if these are good enough to bring profitability. A comparison within multiple contracts can help you identify those paying you well or above average, the ones that need negotiations with, and the ones that are paying lower rates. Start planning to negotiate with the second category and consider dropping one or two from the last.

Review the contract renewal dates and inform the insurance company well in advance about your willingness to bargain or drop. Also, review the policy of increasing reimbursements as laid by the insurance. Does the policy include any waiting period before requesting a raise?

Study your working relationship with the existing insurance. Check for administrative issues or percentage of full compensations and reasons for denials to claims? Accordingly, calculate the worth of being empaneled with the payer or not.

Step # 2 Create terms to negotiate

Collect facts, data, and information to make for a strong justification. Assess your position in the community where you are operating. If you are an old practice in the area catering to a large group of loyal patients or you provide specialist services that no one else is, then your position is strong enough to negotiate your terms for increment.

Review how much your practice contributes to the revenue of the insurance company. Larger volumes are sure to enhance your position.

Consider the last time a raise in reimbursement rate was given and the percentage of increment. If this was increased in the past, argue on the same percentage with the same reasons as stated last time. If there has been no increase in the past, argue about the swelling operating expenses.

Step # 3 Start a negotiation

Once you have understood who you have to negotiate with and on what terms, the final step is to begin the talk.

You can write to or call your representative from the insurance and explain that you need to negotiate your terms of the contract with the company. Before doing this, you must keep a record of the contract renewal dates.

Prefer to meet in person with the decision-maker and interact with an open mind. Don’t get laid by the strength in their argument or the fear of survival. Negotiation is an art and you surely want to excel in it, with facts.

Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.

Get in touch with the leading medical billing outsourcing company to learn more. Call us at (469) 501-1500 or write to us Info@atlanticrcm.com