Strategies for Negotiating ASC Contracts

Negotiating payer contracts is one of the most important decisions an ambulatory surgical center can make. Yet, effective negotiations involve much more than asking for higher rates.

This presentation provides a practical introduction to ASC payer negotiations with a focus on the key issues that influence reimbursement and the financial performance of an ASC. Attendees will learn how to prepare for negotiation, evaluate current payer contracts, identify opportunities for improved reimbursement, and determine which rates and contract provisions should receive the greatest attention. Topics will include understanding an ASC’s payer mix, and costs, evaluating current reimbursement, identifying top CPT codes, addressing contract language that affect payment and developing an effective negotiation plan.

Key takeaways:

• Understanding the fundamentals of ASC reimbursement
• Identify the financial information needed before entering negotiations
• Determine which procedures and reimbursement rates should be prioritized
• Recognize contract provisions that can significantly affect ASC revenue
• Develop a practical strategy for negotiating with payers
• Common mistakes that can weaken an ASC’s negotiating position