You Got The Contract! …Now What?! Part 2: Contract Maintenance
Published in
Government Relations
on August 20, 2025
By Melanie Ewald
In our last article, we discussed the key provisions to be sure you know about your contract. It is critical to understand these provisions to ensure compliance with the contract terms, fulfill your obligations as your business changes, and understand the payer’s obligations and your rights under the contract. In this article we discuss some best practices for managing your contracts once you get them.
Contracting and payer relations efforts do not end with a signed contract. On the contrary, the signed contract is what kicks off the next phase of the payer network development journey – contract maintenance. Effective contract maintenance programs help you to optimize your payer relations efforts to facilitate issue resolution and comply with the terms, ensure ongoing viability of the contracts, and maximize opportunities to grow your business.
Depending on the size and needs of your business, the most effective contract maintenance programs, which can be simple or elaborate, will include some or all of the following.
Document Repository
It is critical to have copies of every contract you have with a payer. As you complete the contracting process, make sure you obtain the fully executed contract including the effective date. Once received, save it and all supporting documentation to a designated document repository (i.e., a designated folder on your network). Make sure to save all correspondence with the payer, credentialing information, fee schedules when applicable, and amendments with the contract. Make sure to give access to the people who need this information so it is easily accessible should an issue arise.
Periodic Review
Set a cadence to perform a periodic review of your contracts. It is considered best practice to conduct this review at least annually. An optimal time may be a few months prior to the renewal date when you are preparing your credentialing documentation. Be sure to incorporate any amendments into your contract review as you determine the return on investment and long-term viability of the contract.
Payer Meetings
Another best practice is to schedule regular meetings with your payer contract representative on at least an annual basis. These meetings are an opportunity to demonstrate your performance and value, highlight the number of payer’s beneficiaries you served, and share any successful outcomes patients experienced during the review timeframe. When necessary, these meetings are also an opportunity to utilize your contract review analysis and strategically discuss any issues you’ve encountered or ask for a rate change.
Be Prepared And Know Your Ask - Every Interaction Is An Opportunity
It is critical to be prepared for these meetings and to know your ask. Be sure to have documentation on hand to support your position for any administrative or claims issue resolution requests. Relevant documentation may include correspondence, claims spreadsheets, and the like, that demonstrates compliance with the payer’s issue resolution processes, contract language that addresses the issue at hand, etc., and relevant data and your value proposition to support any rate changes or product expansion.
Remember this is an opportunity to strengthen the relationship and become a partner with the payer. Consider asking the payer about their pain points and how you can be the solution without increasing their administrative burden. You may also wish to provide the payer with relevant updates from time to time. These regular touch points demonstrate your commitment to the payer’s beneficiaries and to a strong partnership between your organizations. If you are simply not able to schedule a meeting, consider providing the information via email. Be sure to save the emails and any response in your contract document repository. You never know when the documentation will come in handy.
There is no question that payer contracting is increasingly challenging in today’s environment. Implementing an effective contract management program will help you identify viable contracts, be prepared for effective payer conversations, develop stronger payer relationships over time, and better position your business for opportunities.
Click here to read the first article. You Got the Contract! …NOW WHAT?! A Short Series | VGM & Associates