1. 5527 POINTS
    Marlin McKelvy
    President, Consumer Directed Benefit Solutions, Memphis, Tennessee
    I presume from your question that you must be a health care provider or supply some type of service and/or product that is reimbursable under health insurance plans.  First, you need to determine the competitive environment for your product or service in your marketplace.  If you have lots of competition your negotiating position will not be as strong (perhaps nonexistent) as if there is limited competition for your product or service in your marketplace.  The insurance company will know the answer to this question from their perspective so you need to know the answer too before engaging in discussions with insurance carriers.

    Know what the absolute minimum is that you can accept as payment for your product or service.  In today's environment cost is the main driver in provider contracting, any insurance carrier is going to want the lowest possible cost from any provider/vendor they contract with.  What they want to pay could well be below your cost of providing the service.  You will have to make a business decision if such an arrangement would make business sense in the overall context of your total business model.

    What is your unique selling proposition?  What do you offer that a competitor or other product does not provide or provide as well? Do you offer a qualitative advantage, a price advantage, or both?  They are going to ask you these questions and expect you to prove it so be prepared.

    Do research on the insurance carriers.  Does your target market align with theirs?  If your focus is on infant care calling on an insurance carrier who is more focused on the senior marketplace is obviously a waste of everyone's time.  Even among health insurance carriers that from the outside seem to be competing for the same market segment you will find upon closer examination that they all have their areas of market strengths and weaknesses and marketplace segments they focus on.  Some are more oriented towards individual and small group health insurance while others really shine in the large group space.  Knowing this in advance and knowing what your capabilities are will allow you to focus on the prospective carriers best aligned with the marketplace that is also the best fit for your product or service.

    Once you have these basics understood you can begin contacting the various insurance carriers and ask to be put in touch with the department and/or person who handles the insurance carrier's provider contracting and you can let the games begin.
    Answered on April 25, 2014
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