Know what you're paid today
List each commercial payer, its conversion factor, and how much of your revenue it brings. Without that, you can't tell which contract matters most.
Check the contract terms
- How time is rounded
- Whether physical status and qualifying circumstances add units
- Timely filing and appeal deadlines
- When rates can be renegotiated
Build your case
Payers respond to access and quality. Show the facilities you cover, the cases you do and why patients and surgeons depend on you.
Get help
A healthcare lawyer or experienced negotiator can be worth it for your largest contracts.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
Free checklist
Payer Contract Review Checklist
What to check in a commercial payer contract before you sign or renew.
Download free