In a recent Healthcare Business Today article, Thompson Coburn Health Care attorneys Mackenzie Wallace and Ashton Dietrich shared insights on why provider–payer agreements deserve far more attention than they typically receive.
“Provider–payer agreements often feel like boilerplate. In reality, they are among the most financially and operationally consequential documents that a healthcare organization signs,” they wrote. “Too often, providers focus on reimbursement rates while overlooking contractual terms that quietly govern cash flow, audit exposure, dispute rights, and administrative burden.”
Mackenzie and Ashton provide a practical framework for the contract provisions “every healthcare provider and professional should understand before signing—or when evaluating—existing agreements.” Their framework covers critical areas including definitions that often shape disputes, claims‑submission requirements, prompt‑payment obligations, utilization review, record‑keeping expectations, audit provisions, and more.
Read the full article here.
