Re: Re: Negotiations Value from dollars to cents

[Guest guest]

Locke

As a personal note, when I negotiate I always tell people my first offer is always the best. I then do my best to make sure the first offer is the best. You can calculate the time for your visits and RVUs as indicated. When I opened, I did a complicated spread sheet of each E & M service from medicare and used the time portion to back calculate the hourly amount medicare seemed to be reimbursing for care. That answer was $135/hour for my area. I am sure with your research and information gathering techniques you can figure out what this number is for your practice. The allgebra from the equation works in reverse. Collections divided by hours give your average per hour then reverse the RVU calculations to set your practice RVU or conversion factor. You can set your fee from what you calculate.

Then I stick to my promise. When they push lower I add 5%. I never negotiate against myself. But I then I would point out the added benefits of being an IMP. I wish you well.

Last note. The average reimbursement across the country is about $250/patient per year. So 30 patients times 250 is a $7500 question. Typical patients seen twice yearly or 60 visits. So labs and test per patient should generate about $125 per visit.

If you want to negotiate that way, point out that you have priced their product locally and know that they would be paying you cents per day for their profit of likely dollars per day. Then ask them to provide the medical service and you would happily trade them to provide the insurance.

Hope this gives you ideas for digging up quality information for your negotiations. 66 cents per day for primary care is a long way from $10 a day for $300 per month healthcare at the low end. You could then point out that the executives salary is likely 10 times the amount that they would pay you for the year as well. Perhaps to improve the value the executive would resign and save the customer 10 times what you could for providing the care for free.

Good Luck

To: ; Practice Management Issues Sent: Mon, March 22, 2010 11:39:09 PMSubject: Re: Letter to Patients Regarding Canceled Insurance Contract and Negotiations

Thanks for everyone's excellent input so far.

I agree that writing a letter to the editor (unless in the most generic terms), would be counter productive and may even end up with a SLAPP suit (see below).

I have decided to write a tersely worded e-mail instead. :-)

Actually, I did write an e-mail tonight requesting a different representative to negotiate the insurance contract.

Primarily because of the accusation - not so vailed -- in the e-mail reply below from the insurance representative.

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from

to" Locke, MD" <kelly@lockefamilyme dicine.com>

date Mon, Mar 22, 2010 at 3:02 PMsubjectRe: contract

Hi Dr. Locke,

Thanks you for the response. It seems as though a number of providers have come to Humana with the same request of XXXXXX. Humana believes our member’s, your patients, need to have access to quality and affordable healthcare. Therefore, Humana wants to enable peace of mind for our customers and members by providing financial protection and knowledge that will empower them to take charge of their own health and well-being. It is important for both parties to agree on a fair and reasonable contract. Humana is committed to reviewing any request your organization has, but the request must be done in a manner that is consistent with the consumer’s dollar in mind.

Below is a link to an article written by American Medical News:

http://www.ama- assn.org/ amednews/ 2010/03/01/ gvsd0301. htm

Best,

Contracting Executive, XXXX

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Strategic lawsuit against public participation -- From Wikipedia, the free encyclopedia

A strategic lawsuit against public participation (SLAPP) is a lawsuit that is intended to censor, intimidate and silence critics by burdening them with the cost of a legal defense until they abandon their criticism or opposition.

The plaintiff does not normally expect to win the lawsuit. The plaintiff's goals are accomplished if the defendant succumbs to fear, intimidation, mounting legal costs or simple exhaustion and abandons the criticism. A SLAPP may also intimidate others from participating in the debate. A SLAPP is often preceded by a legal threat.

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As an aside to the comment that many IPA members submitted the same request.

It's because most of us have private contracts outside of the IPA -- and these contracts are a % of charges.

My (and likely others who I have had no contact with) approach was to take the best % of Charges contract and request a little more than that.It's a not brainer that most of us would have come up with the same number - giving a little extra to the % so that we could come back down to the same % as the other private contract we have.

Sigh,

Locke, MD