Negotiating disputed overbillings is a vital skill for program integrity professionals, and experts say negotiators who strike the best deals follow rules everyone can practice. Here are three of them from attorney/mediator Thomas Noble and the Harvard Law School Program on Negotiation.
1. Prepare thoroughly
Every negotiation is a combination of facts, dollar amounts, legal issues and personalities, Noble says. Evaluate your leverage and the provider's. Prepare a positioning theme, or a "crisp, memorable phrase or framework that defines the problem you are attempting to solve," Noble recommends, and carefully craft your opening and closure. Plan strategic concessions on points that are either unimportant to you or unassailable parts of the opposing case.
It's also helpful to broaden preparation by thinking beyond obvious information about bargaining issues, a Harvard report advises. Analyze prior meetings for missed opportunities or ignored information to improve future performance.
And remember to anticipate a provider's counter arguments and pull documentation to refute them, as FierceHealthPayer: Anti-Fraud reported.
2. Master the bargaining phase
"Discovering how to engage and persuade the other side is a process of trial, error and adjustment," Harvard notes. So it's essential to stay connected with the other side through deep listening, which requires more than parroting the provider's words. Resist the urge to plan what you'll say next while others talk, the report cautions. "The cheapest concession you can make to the other side is to let them know they've been heard," Noble says.
Another best practice is to be cooperative without letting down defenses. Understand some negotiations are cooperative and some are competitive. "Being too cooperative with a highly-competitive negotiator is a good way to get plucked," Noble says.
It's also important to recognize intimidation tactics. If a provider slams down a briefcase and leaves the meeting, for example, see this as a tactic as opposed to the end of the negotiation (or the world).
3. Commit to successful closure
Prepare a closing checklist, and don't let petty issues block settlement.
Finally, "understand that reaching agreements with people is rarely such an exact science that we can get things down to decimal points," Noble says. "[B]y the very nature of the beast, the 'fair' resolution in every negotiation, the elegant solution, is a range, not a point in space."