Episode 152: Insurance Contracts: Getting In, Getting Paid, and Negotiating

Get ready to take notes. Brian delves into the meat and potatoes of how to get into an insurance contract, how to renegotiate your contract, and how to build relationships and communicate with insurance companies so that you have what you need to provide the best care to your patients.  

Key Takeaways/Points 

  • The insurance industry varies state to state 
  • You have to consider the Hybrid Model (20% of your revenue through cash-based services) 
  • Be a business owner first, a physical therapist second 
  • The individuals win only after the team is winning 

How to get into insurance contracts: 

  1. Differentiate yourself from other providers in network 
  2. Negotiate that you get paid at least the national average 
  3. Make the case: isn’t having more options in town a good thing? 
  4. Need to show them your average collections per visit (Proforma) 
  5. They are afraid you’ll over-utilize care, so average out your average length of stay and report to them that it’s low (9-12).  
  6. You need to diversify your services 

How to renegotiate: 

  1. You have to first establish a relationship 
  2. Communicate how PT is different 
  3. Let them know you have a Compliance Officer 
  4. Understand list of financial terms 
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