What if they say no?

Note the date of their answer and your contract's renewal or anniversary date. Ask again 60 to 90 days before it, with the insurer's newest published rates. A new file each quarter can move the typical rate, so your numbers may be stronger next time.

If an insurer's rate is well below Medicare and other insurers, some NPs stop taking it. Check your contract's termination notice period, how many of your patients use that plan, and your state's rules for continuity of care before you decide.

Groups sometimes hold contracts at higher listed rates than solo NPs. Compare what insurers list for NP groups and platform billing groups in your state with your own rate, and read any group contract closely: a group's listed rate is not what the NP is paid.

Owning your contracts lets you negotiate directly. In states that require it, you will need a collaborating physician; see the box below for your state.