Question 1

How do I know if my contracts are eligible to be renegotiated?

Accepted Answer

Commercial contracts more than five years old are eligible to be renegotiated, often at higher rates. Many payer agreements also contain evergreen renewal language or unilateral amendment clauses that open additional paths to revisit rates. A contract review looks at the age, renewal terms and current rates together before anything is proposed to a payer.

Question 2

Do I have to wait for my renewal window?

Accepted Answer

Not always. Some agreements allow amendment or termination with written notice of 60 to 180 days, and evergreen clauses that renew automatically can usually be renegotiated before they roll over. The review identifies which of your agreements can be opened and when, so you can decide what to pursue now and what to prepare for later.

Question 3

Will renegotiating hurt our relationship with our payers?

Accepted Answer

Payers renegotiate contracts routinely — it is an expected part of the relationship, and requests are handled through the notice and amendment provisions already written into your agreement. Your contracts stay in force while any discussion is underway, so patient billing and claims are not interrupted.

Question 4

We're a small practice. Is this only worthwhile for large groups?

Accepted Answer

No. Even a modest lift in a fee schedule compounds on every future claim for every year the new rates stay in force, so smaller practices with steady commercial volume often see a meaningful difference. The free strategy call is where you find out whether your specific contracts and payer mix justify the work.

Question 5

How can I tell if we're being paid below market?

Accepted Answer

By comparing what each payer actually pays your highest-volume codes against commercial benchmark data for those codes. Most practices have never seen that comparison side by side. Our contract review produces it at the code level, and our public market-rates page explains where benchmark figures come from and why individual payments differ from national references.

Question 6

Why do national benchmark rates differ from what we actually get paid?

Accepted Answer

National figures are averages across many markets, plans and contracting situations. Your actual rates come from your specific signed agreements, and they can sit above or below those references depending on your market, specialty and when the contract was last negotiated. That gap — not the benchmark itself — is what a renegotiation targets.

Question 7

Which codes and payers should we look at first?

Accepted Answer

Start with your highest-volume commercial codes and the payers that cover the largest share of your commercial billing. A small percentage improvement on codes you bill hundreds of times a year does more than a large improvement on codes you bill twice. The review prioritizes the schedule by expected impact.

Question 8

Are rate increases guaranteed?

Accepted Answer

No. Higher rates are not guaranteed — outcomes depend on your payer, market and current terms. What we can commit to is a rigorous review, an evidence-based proposal, and persistent follow-up with the payer. Any performance fee we charge is tied to lift we actually secure, so our incentive is aligned with the result.

Question 9

What happens on the free strategy call?

Accepted Answer

It's a free 30-minute call to discuss your payer agreements, fee schedules and contract-review priorities — no obligation. You can book a time that suits you on our booking page, and we'll cover which contracts look most promising before you commit to anything.

Question 10

What does a contract review involve?

Accepted Answer

You share your payer contracts and fee schedules. We extract the key terms, flag the clauses that commonly cut reimbursement — evergreen renewals, unilateral amendment rights, missing fee schedules — and compare your rates against commercial benchmarks code by code. You receive a written opportunity report showing which contracts are eligible, what the realistic upside is, and what we'd propose to change.

Question 11

What does it cost?

Accepted Answer

The strategy call is free. If you proceed, there is a one-time analysis fee for the contract review and negotiation work, and a performance fee tied to the lift we secure. Our published fee schedule is on the pricing page.

Question 12

How long does the process take?

Accepted Answer

The review itself typically takes days, not weeks. Negotiations with payers run longer — usually several months of proposals and follow-up, and the timing varies by payer. We verify that new rates load correctly and pay at the negotiated level before the work is considered complete.

Question 13

Do we have to change our billing workflow or staff routine?

Accepted Answer

No. Your staff keeps seeing patients and your billing process keeps running as-is. The work happens on our side — analysis, proposals and payer follow-up — with occasional input from you on documents and decisions.

Question 14

How are our contracts and financial details handled?

Accepted Answer

Documents you share are used to prepare your review and are not published or shared. We use the minimum needed for the analysis, and our editorial policy describes the sourcing standards behind the public content on this site.

Questions practice owners ask us

Contract negotiations

Insurance reimbursement

Our process

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