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Build leverage, strengthen negotiations, and protect your revenue
This virtual course contains three-educational sessions giving healthcare leaders a practical, end-to-end framework for managing payor contracts—from preparation and rate requests to negotiating contract language that protects your organization long term. Each session builds on the last, combining data strategy, real-world negotiation tactics, and contract risk management.
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WSHLA Member
Free
Non-Member
Learning Objectives
By the end of this session, participants will be able to:
Analyze their payer mix to identify financial exposure, high-risk contracts, and upcoming renewal opportunities.
Use CPT-level utilization data to identify high-impact services, underpaid codes, and leverage points by payor.
Apply contract modeling tools to compare current and proposed reimbursement scenarios and quantify financial impact.
Benchmark reimbursement and productivity performance using specialty data.
Define clear financial and operational negotiation objectives aligned across leadership.
Develop a data-supported value story and professional value packet to support payor negotiations.
Organize contract documentation and prepare internal teams for consistent, strategic engagement with payors.
Identify contract language and external triggers that justify rate review or contract amendment requests.
Determine optimal timing for submitting requests based on renewal cycles, payor processes, and market conditions.
Structure clear, professional written requests and justification letters supported by data and access metrics.
Navigate payor initiation processes, escalation pathways, and communication best practices.
Track submissions, responses, and documentation to maintain accountability throughout lengthy review cycles.
Set realistic expectations for approval timelines, counteroffers, and common payor responses.
Apply relationship-based strategies that improve responsiveness and increase the likelihood of success.
Interpret key contract provisions and understand their financial, operational, and legal implications.
Identify high-risk clauses such as automatic renewals, unilateral amendments, and “lesser of” provisions.
Evaluate payment methodologies and fee schedule attachments to ensure accurate and sustainable reimbursement.
Negotiate protective contract language related to notice periods, audits, dispute resolution, and amendments.
Recognize red flags in new agreements and amendments that may reduce reimbursement or increase risk.
Implement best practices for version control, contract tracking, and documentation management.
Determine when legal review is necessary to mitigate financial or operational exposure.
Teri Fetsch, CEO Retina Consultants, LLC
Jake Thielen, CEO Valley View Dermatology
Jeff Baird, MBA, CMPE
Lauren K. Harris, FACMPE, CPCO Harris Healthcare Consulting, LLC
Deb Bartel, BA, FACMPE Practice Administrator, Woodburn Pediatric
Brooke Hanna, Senior Manager Aspirion Revenue Cycle Management
