VGM & ASSOCIATESHealthcare MSO
Full Menu Search

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 

Get Connected

Stay up-to-date on the latest resources and news provided by VGM & Associates.

Sign Up for Email

From Our Experts

CMS Finalizes Rule Changing The Next Round Of The Competitive Bidding Program And Updating Other Provisions Related To Provider Enrollment And Prior Authorization thumbnail CMS Finalizes Rule Changing The Next Round Of The Competitive Bidding Program And Updating Other Provisions Related To Provider Enrollment And Prior Authorization Final Rule Analysis from the VGM Payer Relations and Reimbursement team  On Nov, 28, 2025, CMS finalized Final Rule CMS-1828-F that includes updates to the Competitive Bidding Program (CBP) and other provisions related to provider enrollment and prior authorization. Next round is expected to be implemented no later than Jan. 1, 2028. Celebrating the Life and Impact of Mike Hamilton, ADMEA Executive Director thumbnail Celebrating the Life and Impact of Mike Hamilton, ADMEA Executive Director We are deeply saddened to share the passing of our beloved colleague and friend, Mike Hamilton, Executive Director of the Alabama Durable Medical Equipment Association (ADMEA). For more than 50 years, Mike dedicated his life to the durable medical equipment (DME) industry, setting an extraordinary example of hard work, integrity, and unwavering passion. His leadership and advocacy helped shape the industry and improve access to care for countless patients. The Big Sky Association of Medical Equipment Suppliers Welcomes UTAH! thumbnail The Big Sky Association of Medical Equipment Suppliers Welcomes UTAH! The Big Sky Association of Medical Equipment Suppliers is pleased to announce that Utah has officially been accepted into the association as our newest participating state. Big Sky now proudly welcomes all Utah DME/HME, Respiratory, CRT, and Medical Supply companies into our regional association. Utah will have a designated state representative/director—appointed in the same manner as Montana, Idaho, and Wyoming—to ensure strong representation and a clear voice within the Association. Beyond the Shutdown and The Proposed Rule: Key Legislative Updates for the HME Industry thumbnail Beyond the Shutdown and The Proposed Rule: Key Legislative Updates for the HME Industry While the government shutdown and uncertainty surrounding CMS's Proposed Rule have dominated headlines, several important bills impacting HME providers continue to advance. Here's a quick look at three focused legislative priorities: Advocacy in Action: Texas DME Providers Stand Up For Patient Care thumbnail Advocacy in Action: Texas DME Providers Stand Up For Patient Care Texas DME providers are speaking out against proposed Medicaid reimbursement rate cuts that threaten access to essential medical equipment for vulnerable patients. At a recent public hearing, voices from across the state shared powerful stories about the real-world impact of these cuts—some as high as 85%. The Shutdown Has Ended—Now It's Time To Take Action thumbnail The Shutdown Has Ended—Now It's Time To Take Action The recent government shutdown created uncertainty across the healthcare landscape, and the DMEPOS community was no exception. In the weeks ahead, critical decisions will shape the future of our industry. By getting involved early—through advocacy, education, and collaboration—you can help ensure these policies support patients and providers rather than hinder them. Notably, the Continuing Resolution (CR) includes an extension of Medicare telehealth flexibilities through January 2026... New Issue Brief: Why Medicare's Competitive Bidding Program Needs Urgent Reform thumbnail New Issue Brief: Why Medicare's Competitive Bidding Program Needs Urgent Reform The Medicare competitive bidding program for durable medical equipment (DME) was designed to reduce costs—but it's failing patients and providers. A new issue brief from Pacific Research Institute and economist Wayne Winegarden highlights what changes are urgently needed. Champions of Change: DME Advocates Driving Real Change thumbnail Champions of Change: DME Advocates Driving Real Change Real change starts with real people. In this edition of Champions of Change, we're spotlighting two DME advocates who aren't just talking about problems—they're taking action. David Griffin and Gary Rench are showing us what it means to stand up for patients, providers, and the future of our industry.

Give your business an advantage over the competition.

Become a Member