Health Plan Contracting and Negotiation

Dan assists practitioners, independent practice associations, and multispecialty groups contract with health plans and negotiate rates of reimbursement. Health plan contracts are unique. They contain terms and conditions that other agreements do not, many of which stem from the evolving web of federal and state regulations that govern managed care, continuity of care for health plan members, and reimbursement. Dan has over a decade of experience reviewing health plan contracts. Although each client is different and has unique needs, Dan understands the issues which typically rise to the top of the list when it comes to negotiating these types of agreements.

 Reimbursement rates typically take center stage in health plan contracting. As the cost of doing business continues to skyrocket, it is critically important to prepare and implement a long-term strategy for consistently negotiating reimbursement. All too often Dan speaks with potential clients who have not requested an increase in reimbursement for years. In these situations, it is generally very difficult to bring reimbursement up to current market rates in one round of negotiation. The process takes time and can be very frustrating for providers and practices.

 Although every situation is different, in Dan’s experience, the more effective approach is to implement a strategy whereby the provider and/or practice consistently engage the health plan and maintain a continuous dialogue regarding reimbursement. He has over a decade of experience reviewing health plan contracts, engaging health plans in discussion and negotiation, and targeting strategies for increasing rates of reimbursement. If you or your practice needs assistance with reviewing and negotiating health plan contracts, Dan and his team are standing by ready to assist.