Contracts

Deal or No Deal: Negotiating Contracts

 

Negotiating a health plan contract is one of the most important business moves an independent physician can make.

TMA survey data from June 2018 shows that on average, 43% of responding physicians secured changes to contract terms, payments, or both.

Learn How to Negotiate  

Contract Basics

Learn about the basics of contracts in the articles below:

Five Tips for Negotiating Contracts

• The Basic Elements of a Contract

• Physician Prices, Fee Schedules, and Managed Care Contract Offer and Acceptance

• Is There a Cooling-Off Period for Physician Contracts?

• Managed Care Contracting: Contract Evaluation Service

• Monitor Payer Contracts to Help Manage Revenue

• Payer Contracts Warrant Attorney Review

Amending Contracts

Generally, in Texas, a contract modification must meet all of the elements necessary to form a contract at the outset. This means there must be an offer and an acceptance. One party cannot modify the contract terms without the consent of the other, for such a modification would lack the other party's acceptance.

See How Contract Clauses Modify the General Rule

Contract Clauses

Managed care contracts and regulations can be a jungle of legal language, and physicians who do not carefully pick their way through the various clauses can be in for a nasty surprise.

• Definitions in Managed Care Contracts

• Indemnity Clauses in Managed Care Contracts

• Not-So-Silent PPOs

• Secured Transactions

• Termination Clauses in Managed Care Contracts

• Texas Department of Insurance Rules and Managed Care Contract Clauses

• The 'Most Favored Nation Clause' of Managed Care Contracts

• The Covered Services Clause of Managed Care Contracts

• The Nondiscrimination Clause of Managed Care Contracts

Calculating Payment Terms

To make wise decisions about accepting a managed care contract, you and your practice administrator need a good understanding of how the contract payments relate to the cost of providing services in your practice. 

• Your Payer Contracts: Money Makers or Money Drains?

• Flex Your RVUs