Taking Charge: Steps to Evaluating Relationships and Preparing for Negotiations

Physicians face a significant challenge in understanding and negotiating the complex and confusing provisions contained in the third party payor contracts with which they are confronted. CMA is pleased to offer our members this Toolkit as an educational resource to help members thoughtfully consider whether and when to enter into agreements with payors and how to prepare for negotiations when a payor relationship is desired.

CMA’s Managed Care Contracting Toolkit includes two valuable guides. The first is Taking Charge: Steps to Evaluating Relationships and Preparing for Negotiations - A Focus on Payor Contracting. Taking Charge is designed to guide the physician through the contract evaluation and negotiation/renegotiation process. It also provides the physician and his/her office staff with practical tips and tools to complete a contract and fee schedule analysis, prepare for contract negotiation or renegotiation, and issues to consider after the contract is signed. (NOTE: This portion of the Toolkit can be downloaded as a pdf file free of charge in the members-only section.)

The second section of the Toolkit is Managed Care Contracts Deciphered: The Physicians’ Guide to Their Rights and Obligations. To help physicians navigate their way through managed care contracts, CMA has prepared this guide to assist physicians (1) identify contract terms that pose potential problems, (2) understand the issues involved and, (3) if applicable, be aware of the relevant law that relates to those areas. This guide also provides sample contract language to consider where a physician believes negotiation is desirable and feasible.