Insurance Negotiations: Setting Your Practice Up For Success

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Discover how to effectively prepare for and conduct successful negotiations with payors. This comprehensive four-part session will guide you through collecting the necessary data and mastering the negotiation process with a payor, ensuring you receive fair compensation for the care you provide to children.

NOTE: This series was originally presented at the 2023 NCE SOAPM Section H session. Although the content was excellent, it was not recorded. Therefore, PCC reunited the team to redo the session and ensure the pediatric community will have access to a recording that can be widely shared!

Part 1: Getting Your Data Ducks in a Row Chip Hart will guide you through the essential data needed to maximize your success when negotiating with insurance companies. There's nothing more powerful than a pediatrician armed with data!

Part 2: Finally at the Table - Managing Contract Negotiations What should you do when you have a payor at the table? Susanne Morgana Brennan will lead you step by step through the process of successfully negotiating with an insurance company. It is a lengthy process, and by the end of this session, you'll know all the steps.

Part 3: Understanding Business Implications - Navigating Possible Outcomes Paul Vanchiere will explain the business implications of your insurance negotiation. Specifically, you'll learn how to evaluate an offer from a payor and determine its impact on your business.

Part 4: Contracting Tips and Tricks - Practice Manager's Perspective Kimberly Brennan provides a real-world perspective. As a practice administrator, she'll offer actionable tools and guidance on creating and maintaining your practice's payer contracting program. This includes a simple Google Sheet template for contract organization.

 

Picture of Paul Vanchiere, MBA

Paul Vanchiere, MBA

For over 15 years, Paul has dedicated himself exclusively to addressing the financial management, strategic planning, and succession planning needs of pediatric practices. His background includes working for a physician-owned health network and participating in physician practice acquisitions for Texas's largest not-for-profit hospital network, giving him a distinctive insight into the healthcare sector. Paul is adept at conducting comprehensive financial analysis, physician compensation issues, and managed care contract negotiations. He established the Pediatric Management Institute to offer a wide range of services tailored to pediatric practices of all sizes and stages of development, with a focus on financial and operational challenges. Additionally, Paul is actively involved in advocacy efforts to ensure healthcare access and educational opportunities for children with special needs.

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