Negotiating with insurance companies

[stickyshift]

How many of you feel that you or your group has had a good history negotiating rates for your services with insurance companies? What would you consider to be good reimbursement, as a percentage of Medicare? When insurance companies try to lower reimbursement, how often are you successful in fending them off?

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[LADoc00]

Depends. Ive done well, if you are in a bigger market even if you have a crazy % market share you seem to have many more issues.

Seems they do some type of "at risk" calculation meaning if they have a group in a huge catch area that might potentially hoover up a ton of business they play hardball, small players seems to dart through cracks however unscathed.

This would basically completely shred the "bigger is better" narrative most groups try to spout. Basically the bigger you are, the more the insurance can win from directly knocking you down, the more effort and the more hardball they are willing to play. Solo guy in a smaller market goes basically unnoticed.

The "stay off the radar at all costs" narrative seems to function far better in reality. So much so that alot of private practice consolidation I feel is almost being guided by a secret hand to the direct harm of the smaller elements being bunched up together in geographic sectors.

 

[AZpath]

Depends. Ive done well, if you are in a bigger market even if you have a crazy % market share you seem to have many more issues.

Seems they do some type of "at risk" calculation meaning if they have a group in a huge catch area that might potentially hoover up a ton of business they play hardball, small players seems to dart through cracks however unscathed.

This would basically completely shred the "bigger is better" narrative most groups try to spout. Basically the bigger you are, the more the insurance can win from directly knocking you down, the more effort and the more hardball they are willing to play. Solo guy in a smaller market goes basically unnoticed.

The "stay off the radar at all costs" narrative seems to function far better in reality. So much so that a lot of private practice consolidation I feel is almost being guided by a secret hand to the direct harm of the smaller elements being bunched up together in geographic sectors.

Your lucky if you can get a contract at all if your a group small.
They play hard ball at all levels. The only thing that works is persistence.
If you offered some thing that is joke price wise . Walk away.

 

[AZpath]

% of MC. Depends on your market. Some markets 1.25% is still a good target others your lucky if you get 65%.

I have been offered 45% of MC and a finally end up with 120%.
It takes effort that is all I can say.

 

[LADoc00]

Huh, I really have no have problem whatsoever getting contracts. I understand the concept, but it has literally never been part of my experience. That said, there are a number of insurance players I choose to be out of network.