The next time an insurance company invites your practice to join its network, AI may help prepare the responses you receive. Questions, counteroffers, and requests for information could move through the contracting process much faster than you expect.

For mental health practice owners, that is an appealing possibility. Running a practice already requires balancing patient care with business responsibilities. Less waiting between emails can make it easier to evaluate a new network opportunity and reach a decision.

A faster process still requires preparation. You need to understand the proposed reimbursement, know what your practice needs, and recognize that an initial offer may be open to negotiation.

Understand Why the Insurer Wants Your Practice

An insurance network needs clinicians who can provide care to its members. For a health plan selling coverage to employers, access to providers is part of what makes its offering useful to employees and their families.

That creates a shared interest: the insurer wants a network that serves its members, and your practice wants reimbursement that supports the care you provide.

Curative offers an example of a model focused on reducing patients' out-of-pocket costs. Its business health plan overview describes $0 copays and $0 deductibles for covered in-network care and preferred prescriptions once members complete a Baseline Visit.

For a mental health practice, the potential appeal is clear. Patients may face fewer financial barriers to attending appointments, while the clinic gains another way to serve them. Whether that opportunity works for your practice depends on the proposed terms and the patients the plan covers in your area.

Start With the Actual Reimbursement Amounts

A percentage of a fee schedule tells you how payment is calculated. To understand what you would receive, you also need the underlying dollar amounts.

If an offer promises 90% of a payer's fee schedule, for example, you cannot assess it until you know what that schedule assigns to the services you provide. A fee schedule lists payment amounts for particular services or billing codes. Request the amounts that apply to your practice's work.

This was the starting point when psychiatrist and RipsyTech founder Tom Tarshis received a contracting invitation from Curative. The proposal referenced a percentage of its master fee schedule. He requested the actual rates, received them promptly, and used those numbers to evaluate the offer.

The American Academy of Family Physicians' Family Practice Management article, “Negotiating a Contract With a Health Plan”, recommends obtaining the fee schedule for the services your practice provides and asking whether the payer is willing to negotiate an individual schedule.

For mental health practices, the review should reflect the services you actually deliver. Look closely at the codes you use regularly and how the proposed reimbursement would support the time and resources those appointments require.

An invitation to join a network gives you an opportunity to ask questions. Understanding the numbers is the first step toward deciding whether to participate.

Treat the Initial Offer as an Opening for Discussion

Receiving a proposed rate does not mean you have to accept it. You can ask whether there is room to negotiate and present a counterproposal based on your practice's needs. The payer may or may not agree, but asking allows you to explore whether workable terms are possible.

Before responding, identify:

The services you provide most often and their proposed reimbursement.
The rates needed to support your practice's operating budget.
The number of plan members in your service area.
The care your practice could make available to those members.

These details connect your request to the actual opportunity. A plan with members who need your services may be a useful fit, provided the reimbursement supports your ability to deliver them.

Mental health treatment also deserves a clear explanation of its structure. Some patients need weekly appointments or other ongoing care. That pattern is different from an occasional medical visit, and it affects how a practice plans its capacity and finances.

A productive counterproposal explains both the amount you are requesting and why it fits the services you provide. Specific information gives the contracting team something concrete to evaluate.

AI Can Make the Process More Responsive

One of the most promising uses of AI in insurance contracting is reducing the time between exchanges.

In Tarshis's early negotiations with Curative, responses arrived unusually quickly. Within about a week, the exchange had covered ground that, in his experience, could otherwise take months. He was able to request rates, respond with a counterproposal, and obtain information about the plan's membership in his region.

When he asked about AI's involvement, Curative explained that its network team consisted of real people who used AI tools to speed up drafting responses, with the responses reviewed by the team. The AI assistance was on the insurer's side; Tarshis evaluated the offer and prepared his responses using his own experience.

That example points to a practical opportunity. AI-assisted communication could help clinicians get the information they need with less waiting and fewer follow-ups. Faster exchanges also make it easier to keep track of an active negotiation alongside the rest of a practice owner's responsibilities.

Speed is one useful measure of the process. The terms themselves still need to meet your practice's needs.

Ask How the Contracting Process Works

Understanding who reviews proposals and authorizes changes helps you direct your questions to the right place.

When AI is involved, useful questions include:

What parts of the process do the AI tools assist with?
Who reviews counteroffers and approves changes to reimbursement?
How should requests that need additional consideration be submitted?
Who can clarify a question about the proposed terms?

These are practical questions about how to work with the contracting team. Clear answers help both parties move through the negotiation efficiently.

Your preparation remains valuable regardless of how responses are drafted. Knowledge of your patient population, services, and operating costs gives you a basis for evaluating an offer and explaining a counterproposal.

Mental Health Business Moment

In this week's business moment, Tom’s clinic offers an example of how to make patient consent for AI-assisted documentation more explicit.

An updated consent process asked patients to actively select whether they agreed to AI-assisted documentation. Among the first 35 new patients who completed that process, all consented.

That is an encouraging early observation from one clinic. For practice owners, the practical lesson is to pair an explicit choice with a straightforward explanation. Explain how the tool will be used, provide a clear way to consent or decline, and give patients room to ask questions so they can decide whether they are comfortable with AI’s role in their care.

Bring Your Business Knowledge to the Negotiation

AI-assisted contracting offers the possibility of a more efficient exchange between insurers and clinicians. Timely responses can help a practice assess an opportunity while it is still fresh, and readily available information can support better decisions.

The clinician's contribution is knowing what makes the agreement workable: clear reimbursement amounts, a relevant patient population, and rates that support the care the practice provides. Bring that information to the negotiation, ask questions, and use the initial proposal to begin a substantive discussion.

If you’re in the early stages of starting a practice, we’ve created a free course that walks through how to set up everything, all in under two hours.

Learn more at ripsytech.com/practice.

Have a question or topic you’d like us to explore? Contact us at sitandstay@ripsytech.com.

And don’t forget to subscribe to the Sit and Stay Podcast for more insights on running a thriving mental health practice.

See how RipsyTech helps practices run more smoothly. Schedule a demo.

Your Next Insurance Contract Could Be Negotiated by AI