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Advice on negotiating insurance allowable rates

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  • Advice on negotiating insurance allowable rates

    I just joined a private practice group and am starting to delve into the group's billing practices.

    It seems to me that they have low contractual allowable billing rates from private insurers relative to other practices in the area.  I have a friend who works in the same specialty in my area and he once mentioned to me how much he collects for a specific E&M code and CPT code from a major insurer in our region.  Sure enough, this was a bit lower than what I will be collecting with my current contracted rate for my new practice.

    I asked our billing manager and office manager about when rates were last negotiated but just received blank stares.

    Any advice on how to negotiate allowable rates with private insurers, especially if this has not been done on a regular basis?

     

     
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