Posts

10 Dirty Negotiation Tactics and How to Beat Them

I believe my first series of blog posts years ago were specifically about insurance negotiation tactics.  It’s been a while, and John Canning sent me this link to share.  Although it’s a bit sp[censored], I can certainly confirm that I’ve seen the insurance companies use every one of these tools. Quick read, a good reminder.

Small Practice Takes On Big Payer, Round 77

Over on PartnerTalk (the PCC user mailing list), one of our clients mentioned trying to get UHC to the table three times and failing.  I pointed out that the insurance companies have no motivation to pay attention to a small pediatric practice until you force them to do so – namely, by dropping them. I …

We Win Insurance Fight #750

Yet another unscripted example of a client successfully fighting the managed care companies for a better fee schedule.  Verbatim: I just followed your steps–letter to our patients with a drop-dead date about 5-6 months ahead, encouraged them to call their benefits people (this plan covers a lot of small unions; it’s really just a claims …

Insurance Negotiation Continues

The very first blog I ever wrote was about one client’s fight with an HMO.  Now, more than two years later, I continue the battle.  Look at this funny message I received today, edited for brevity and privacy: As promised, the outcome of my recent [HMO] “negotiations.”  At the risk of hearing Chip’s “I told …

Quick (Aetna, SOAPM)

I’m busy writing another piece for the SOAPM newsletter and it’s really taking up my time. I’m truly honored to be given the opportunity to provide them comment but, whew, it takes a lot of work. That is, it’s one thing to ramble on in a blog (this is a good example), but it’s a …

Insurance Negotiation Story #175

I’ve ranted about how “getting big” is not an automatic recipe for success when negotiating with insurance companies. It’s rare, in my experience, that the cost of merging offices is outweighed on the contract end. Here’s an email I got just before the weekend. This isn’t a 15-20-40-80 doctor practice. This isn’t the only pediatric …

Multi-year Contracts

Over the last month, I have had three practices ask me about multi-year contracts.  What do I think of them? Multi-year contracts can be great.  Why not?  It’s one less contract to worry about for 2-3 years.  Presuming you do it properly, of course.  Sometimes, the payors are willing to give price increases over time …

All For One! (The Myths of Merging)

I took another “We Think We Need To Merge!” call today from a thoughtful practice on the east coast. A couple small groups, aimed at getting a more fair piece of the pie. Can’t say I blame their intent. Practice mergers are like tattoos – they sound good when you and all your friends have …

Sometimes They Write Themselves

Paraphrased from a customer message on our client-only mailing list today: I was wondering what you think of Coventry Health/Health First. I guess they have replaced old Health Care Value Management. We have been noticing that since Coventry has replaced HCVM their reimbursement has been ridiculously low… I called him and complained. Someone called back …

Hello, World!

Let me open this blog with a summary of the phone call that inspired me to begin recording my experiences consulting with private pediatric practices around the country. A long-time customer of PCC’s called me from San Antonio two weeks ago. I’ve always enjoyed my conversations with him, as it’s delightful to work with someone …