I’m going to take some liberties with an email I received from one of our customers today. Very typical. He’s been an “honor student” lately and has increased the revenue for his practice by tens of thousands of dollars simply by asking for what they should have been getting all along. After picking off some of the low-hanging fruit, he’s going after the big fish (I love mixing metaphors). Here’s his update on negotiations:

Empire: was pretty easy, the rep took my data and brought it to the next level right away.

Magnacare: they had asked what % above Medicare that I want? Waiting to hear.

GHI: also asked what % of Medicare I want. Also waiting.

Blue Cross is tough. It was a painful discussion with rep who did
not want to take it to next level. Said they do not negotiate, they are
too big.

Healthnet: no response

HIP/Vytra: XXX% Medicare, done deal

Multiplan: XXX%, XXX% over two years then we will renegotiate again.

There’s a lot to learn, here.

First, I truly believe the BCBS rep is bluffing. They do negotiate, but you have to drop them and have a reason for them to want you back. If you are a decently-sized pediatric practice with enough patients, they will want you back.

Second, I love when the reps - who can’t do anything about it anyway - ask you what %age of Medicare you want. As though it will actually affect the discussion. It’s simply a delay and sometimes-get-lucky tactic.

Think about it: the practice is either going to say, “Well, we want 250% like you pay some of their other specialties,” some silly number like “100%,” or, “140% to start.” Either of the first two options simply serve to muddy the waters, delay the contract, and perhaps even get the insco just what it wants (another 3 years < 110% of Medicare). How often do the reps even get the 3rd response?

Not often enough.