It's email like this that keeps me going.

To set the scene: typical practice in the northeast. More than 4 pediatricians, fewer than 8. In an area whose payers average 80-85% of Medicare (that's no typo). Surrounded by practices whose heads have been in the sand forever and feel like their only recourse is to massively merge, if I may split an infinitive.

The results of a 1-on-1 negotiation below. No special tricks, no high powered attorneys, no animals were harmed. If this practice can do it, you can too. Here's a copy of the official MCO email:

Dear Dr. [X]:

First, I need to apologize for the delay in responding to your e-mails. I appreciate your patience throughout this process.

I am attaching our counter proposal for your approval.

Here is an overview of the terms.
* Group Contract effective 12/1/07
* 110 % 2007 Medicare with immunizations & preventive codes carved out

Believe me, for this practice to get 110% of Medicare is a huge leap forward.

How hard was that?