NYPTA Continuing Education

Contract Negotiation: To Sign or not to Sign
and
Negotiating with Insurance Companies

Erik van Doorne, PT, DPT, COMT, Cert. MDT

September 13, 2008

Courtyard Marriott, New York LaGuardia Airport
90-10 Grand Central Parkway, East Elmhurst, NY 11269

Pricing Information:

Register by August 29 for Early Bird Pricing:
Member : $195.00
Non-Member: 320

August 30 - September 5 Pricing:
Member: $250.00
Non-Member: $375.00

4 Ways to register!

1. Call the Chapter office at 518-459-4499 and register over the phone!
2. Print the registration form, fill it out and mail it to 5 Palisades Drive, Suite 330, Albany NY 12205
   
3. Print the registration form, fill it out and fax it to 518-459-8953
   
4. Register On-line!

Erik van Doorne, PT, DPT, COMT, Cert. MDT

Dr. Erik van Doorne, PT, DPT, COMT, Cert. MDT graduated from the Hanzehoge school in the Netherlands with a Bachelors of Science in Physiotherapy and received a Doctorate of Physical Therapy with distinction from Simmons College in Boston. He is active in the American Physical Therapy Association (APTA) and is the delegate to the RUC/HCPAC at the AMA representing the APTA. Erik is a consultant to the APTA Advisory Panel on Reimbursement Policy and Planning and has a decade of experience in negotiating with insurance companies. He has been able to secure deals which lead to millions of extra money for physical therapy. In his role as consultant Erik has helped chapters, companies and private practices with education and actual negotiations with third party payers. Erik has worked in three different countries with three different healthcare systems which gives him a unique perspective on receiving payment for physical therapy services.

Erik is the owner and president of a specialized clinic in conservative spinal management and orthopedic manual physical therapy in Wilmington, Delaware and has a consulting business focusing on reimbursement and practice management related issues.

Contract Negotiation: To Sign or not to Sign

The “Contract Negotiation; To Sign or not to Sign” presentation is an introduction to physical therapy contract negotiations with third party payers. Physical therapists in general are lacking basic practice management education and skills including contract negotiations and knowledge. This lack of education and knowledge in conjunction with not reading and/or understanding third party payer contracts is a “lethal” combination for private physical therapy practices. Most third party payers are aware of the fact that physical therapists do not read their contracts, do not understand contract language and do not know what to look for in these important contracts. It is well know in the industry that most physical therapists will sign any contract that comes across their desk.

This presentation will discuss third party contracts, what to look for before you signs contracts, what specific language means for your business and what clauses to never sign. This presentation will also review what is negotiable and what is not in a contract and how to avoid their business from signing bad contracts. In a time of decreasing reimbursement signing the right contracts is key to the survival of private practices and maybe to the profession in general.

The second part of the presentation is interactive. Participants will be divided into groups and will be given specific contract language. This contract language was collected by me from real outpatient physical therapy contracts from different states around the country. All groups will be asked to read to language, determine if the language is reasonable and if they are willing to sign contracts with this specific language and if not what would be their suggestions for acceptable language to be incorporated into the contract. This exercises will make physical therapists become familiar with real contract language, will make physical therapist think about the pro’s and con’s of specific contract language and about alternative suggestions of language during contract negotiations. Hopefully this exercise will make PT’s read their contracts, feel less threatened about contracts and their specific language and make them ask for help if they do not understand the full scope of the contracts that they sign. Ultimately the goal is for all physical therapists to stop signing contracts below cost and to stop selling our important product at a price that does not appropriately reflects it value.

Negotiating with Insurance Companies

The Negotiating with Insurance Companies presentation will address the do’s and don’ts of negotiating with insurance companies. Physical therapists, as clinicians, often have no experience or training in negotiating techniques and strategies. Almost no physical therapy literature addresses this issue and little literature from other health care professions deals with the negotiating process. Other factors contributing to weak negotiating skills among physical therapists and other medical practitioners include lack of time and discomfort with the very idea of negotiating. This presentation will give attendants the basics of negotiating and the specifics of negotiating with insurance companies. The unique area of negotiating with insurance companies is difficult, full of mines, pitfalls and legal issues. These are normally one of the most difficult negotiations physical therapists will encounter in their career. This presentation should be seen as the first step in mastering the much needed skill of negotiating and hopefully will lead to physical therapists being a more formidable force in negotiating with the insurance industry.

The second part of the presentation is interactive and role playing. Participants will be divided in teams with one group representing the payer and the other group representing the physical therapy community. Both groups receive a statement which includes a topic and a starting point to a negotiation. All groups will separately prepare for 10-15 minutes to agree on a strategy, a final goal, an acceptable first step in the negotiation and start the fact finding mission to reach the goal described in the statement. After the preparation period participants will be asked to role play the start of the negotiation in front of the other participants. All participants will receive feedback on their performance linked to the content of the course including verbal and non-verbal communication issues, planning, BATNA, walk away point, opening statements and other important features of the groundwork of a successful negotiation.

Session Location:

Courtyard Marriott, New York LaGuardia Airport
90-10 Grand Central Parkway, East Elmhurst, NY 11269

Session Room: Courtyard I

Hotel Reservations: 718-446-4800

Pricing Information:

Register by August 29 for Early Bird Pricing:
Member : $195.00
Non-Member: 320

August 30 - September 5 Pricing:
Member: $250.00
Non-Member: $375.0

4 Ways to register!

1. Call the Chapter office at 518-459-4499 and register over the phone!
2. Print the registration form, fill it out and mail it to 5 Palisades Drive, Suite 330, Albany NY 12205
   
3. Print the registration form, fill it out and fax it to 518-459-8953
   
4. Register On-line!

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