Contract negotiation
Get paid what your contracts should be worth.
We benchmark your payer rates against Medicare and the local market, build a contracting strategy around your top codes, and renegotiate on your behalf — so you're paid what your work is actually worth.
The basics
What is insurance contract negotiation?
Most practices sign payer contracts once and never revisit them — while rates quietly fall behind the market. Contract negotiation is the process of reviewing those agreements, benchmarking your rates against Medicare and local norms, and renegotiating with payers so your reimbursement reflects the value of your care. We handle the analysis, the strategy, and the back-and-forth with network reps.
What we handle
The whole negotiation, handled for you.
- Review of your current managed-care contracts and fee schedules
- Rate benchmarking against current-year Medicare and local market rates
- Identification of which payers are worth renegotiating first
- A contracting strategy built around your top CPT codes and revenue mix
- Direct renegotiation and follow-up with payer network reps
- Tracking of contract expiration dates and terms so nothing lapses
How it works
A strategy built on your numbers, not guesswork.
Strategy
We identify your key payers, benchmark current market rates, and build a contracting strategy around your practice's revenue mix and goals.
Evaluate
We analyze each contract weighted by your most frequent CPT codes as a share of annual revenue, then compare every payer's fee schedule to current-year Medicare.
Renegotiate
We assess each contract against your requirements, confirm the rates are actually in the contract, and renegotiate — typically targeting a percentage of Medicare appropriate to your specialty and market.
Expect the full process to run roughly 90 days to six months — payers move slowly, and constant follow-up is what gets a deal across the line. We stay on your reps so you don't have to.
Questions
Common questions
How long does it take to negotiate an insurance contract?
Plan for roughly 90 days to six months. Payers commonly take 30–45 days just to acknowledge a request, 45–90 days to send an initial proposal, and 90–150 days to finalize. Persistence with your network rep is what keeps it moving.
What rate should I expect?
It varies by specialty, payer, and market. A common benchmark is 150–200% of current-year Medicare, but the right target depends on your CPT mix and local rates — which is exactly what we analyze first. We don't promise a number we haven't modeled.
Which payers should I renegotiate?
Not all of them at once. We prioritize by how much each payer contributes to your revenue and how far below market its rates are, so you spend effort where it pays off.
Do you track when contracts expire?
Yes — we track expiration dates and terms so you're never caught renewing blind or letting a below-market rate roll over automatically.
Will renegotiating risk my existing contract?
Renegotiation is a normal part of payer relationships. We approach it professionally and keep you in-network throughout; the goal is a better rate, not a disruption to your patients.
Think you're underpaid?
Send us your payer mix and we'll tell you where your rates stand against Medicare — free.