Will insurance companies be upset if I try to negotiate my rates?
A practical, informational guide for therapists and behavioral health providers. Not legal advice, just a realistic read on a risk providers worry sometimes about.
This is a typical administrative request.
A fee-schedule review request is, from the insurer’s side, an ordinary administrative event. Provider relations and contracting teams field them as part of the job. A request that’s professional and specific reads as routine, not as a provocation.
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Setting the termination fear aside, here’s what tends to happen after a fee-review request:
Some insurers say yes. They review the request against their fee schedule and offer an adjustment. It may be less than you asked for, but any increase that holds applies to every session you bill going forward.
Some say no, for now. A rejection isn’t necessarily final. Asking what criteria they use and what would strengthen a future request turns a “no” into useful information for the next review cycle.
Some don’t respond promptly. Common, and frustrating, but not a signal of risk: fee-review requests often sit in a queue. A polite follow-up is normal and expected.
How to keep a request low-friction.
The way a request is framed does a lot of work. A few things that keep it firmly in “routine business correspondence” territory:
- Lead with the data, not a grievance. Reference where your rate sits in the insurer’s own published rate filings, for 90837 or whichever codes you bill most. A request anchored to the insurer’s own numbers reads as a correction, not a complaint.
- Keep the tone collaborative. You’re a contracted partner requesting a contract review. There’s no need for ultimatums, and threatening to leave the network is rarely necessary and changes the character of the conversation.
- Share your special qualifications. Do you have a wealth of experience with a certain population? Specific highly valued training? Let the insurance company know.
- Share your commitment to their plan members. Do you have many clients from a particular insurance company? Let them know that you are committed to caring for their members well.
- Request a specific, calibrated rate. A precise request, such as the 50th or 75th percentile of your peer group, is easier to act on than “please pay more,” and it signals you’ve done the homework.
- Send it to the right team. If you have their information, contact the person you worked with on credentialing initially. Otherwise, reach out to provider relations, provider contracting, or network management, rather than general provider services. Reaching the right inbox does much of the work.
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Related questions.
- How to negotiate your insurance reimbursement rates The full walk-through, from finding your number to sending the request.
- Are insurance reimbursement rates confidential? The public data behind a data-backed request.
- Why asking for a rate review feels so hard The part of negotiation the how-to guides skip.
This guide is provided for informational purposes. We are not attorneys, and this is not legal or contractual advice. Your participation agreement governs your specific situation. Consult your own advisors regarding your insurer contracts and obligations.