Negotiating with Insurance Companies: When to Walk Away
When should I walk away?
This is probably one of the most difficult decisions to make. There are situations when it does not make sense to continue negotiations. For example, you may have covered the same issues repeatedly and the other side is not willing to negotiate. Or the other party is not showing you the respect you deserve as members of the provider community and the community at large.
Walking away from the negotiating table sometimes is inevitable when the decision makers are not willing to meet with you but instead send representatives who have no decision making power.
If you cannot get the other side to focus on your main objective or they have demonstrated that they do not want to negotiate, you are faced with the option to stop negotiating. Walk away because you are wasting your valuable time. Discuss this with your team of negotiators, but if you all agree, end the current discussions. Inform the other side that you do not see enough improvement to warrant your time away from your patients. Never burn any bridges because it is very likely you will have to deal with the same people or organization at some other time in your career or time in office.(5)
Another option may be the use of a mediator. This could be a neutral health care attorney who has experience in health care negotiation or someone from your state's insurance commissioner's office or the department of insurance.
Keep in mind that the other side is often more skilled in negotiating than you are, but nobody knows more about physical therapy than you do. Master some negotiating techniques and become comfortable with your personal style of negotiating. This will take time, effort, and practice. Good negotiators can call on a range of negotiating styles to use in different situations. Developing multiple styles of negotiating makes you more flexible and adaptable to all different situations during the negotiating process. (6)
Learn from the people who have done it before. Talk to people who negotiate for a living. Read about techniques, tactics, and skill development. Practice your skills. Remember: Everything in life is a negotiation. Every relationship is full of negotiating experiences. Practice does make perfect. Physical therapy as a doctoring profession should broaden all the aspects of effective communication and every physical therapist should look at mastering the skill of negotiating as an effective leader in the current and future health care environment. Negotiating with insurance companies will never end. So be prepared and get good at it.
1. Chesanow N. The negotiating process: how to get what you want: do you want a less costly office lease, a higher salary, more vacation time? Try these tips. (Essential skills). Ophthalmology Times. 2005;30.19,Oct1:104.
2. Schultz I. 3 keys to negotiating a better managed-care contract: Know why your practice is valuable, research the panel you're joining, watch for pitfalls. Ophthalmology Times. 2000;25.9,May1:47.
3. 8 steps for highly effective negotiation. Letting the other person have your way. Rockhurst University Continuing Education Press; 2004.
4. Fisher R, Ury W, Patton B. Getting to Yes. Negotiating Agreement Without Giving In. 2nd Edition. New York, NY: Penguin Books; 1991.
5. Museler MC. Negotiating Skills in the Practice of Dietetics. Top Clin Nutr 2004: Vol 19,(4),303-307.
6. Denning JF. Tips on negotiating will pay big dividends later. Ophthalmology Times. 2001;26.21,Nov1:27.
For More Negotiating Information
- Cohen H. You Can Negotiate Anything. New York, NY: Bantam Books; 1982.
- Ury W. Getting Past NO. Revised edition. New York, NY: Bantam Books; 1993.
- Mills H. The Streetsmart Negotiator: how to outfox, outmaneuver, and outlast your opponents. New York, NY: AMACOM; 2005.
- Camp J. Start with NO: The Negotiating Tools That the Pros Don't Want You to Know. New York, NY: Crown Business; 2002.
- Hindle T. Negotiating Skills. New York, NY: DK Publishing, Inc.; 1998.