critical changes insurers may have thrown in, and identifying what works and what doesn’t. “It’s imperative, but I’m glad my partner likes to do that. But you give me the details, and I’ll take that vision and go make it work,” Dr. Curran said. If nothing else, he recommends physicians hire someone to help them through the process. “But you can’t make things happen without the physician. You have to
take ownership of what’s going on in the practice and what you’re willing and able to do and not do, and make sure you are communicating that to as high a level as you can in the insur- ance company or employer group,” Dr. Curran said. “Any doctor not reading his or her contract is making a huge mistake. You have to go over them with your billing folks, with your staff, or get professional help because there are nuances insurance companies will
throw in that can put a wrench in your practice.” Dr. Callas also likes to be front and
center in contract negotiations and agrees it’s worth the money to get counsel to walk physicians through the minefield of contract language. But the buck doesn’t stop there. “Attorneys can help you decipher
what you are signing before you sign it. But they are not the experts in health care. Physicians are,” Dr. Callas said, reiterating that physicians know what it takes to maintain their prac- tices and access to care. Mr. Stern says physicians have to
decide where their strengths lie and where their time is best spent. But it is neither uncommon nor inappropri- ate for physicians to send an office manager or other staff member into negotiations after discussing desired contract terms. If after much back and forth dis-
cussion, communications with a health plan stall, Mr. Reiner doesn’t settle there. Physicians, he says, are his best deal-clincher. Mr. Reiner typically sets up a conference call or meeting with the insurer, “and when I’ve tapped out information about the practice and the unique services they provide, it’s the physician who’s passionate about what he or she does. When payers hear that passion, it goes a long way in eliciting movement on the contract.” Of course, it’s important to recog-
nize when you’ve reached that point when insurers just won’t budge, he notes. “But if you truly believe that your practice deserves an increase, and you have something unique on the table that gives you leverage and that you are passionate about, I see you being successful.” n
Amy Lynn Sorrel is former associate editor of Texas Medicine.
48 TEXAS MEDICINE March 2017
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