When the Insurer Used AI: Better Rates and a Revised Contract in Five Weeks
A good insurance contract needs to support both the care you provide and the work required to run your practice. Reimbursement matters, along with the terms for submitting claims, receiving payment, resolving disagreements, and ending the agreement.
That gives mental health practice owners several areas to explore during a negotiation. An overall rate increase is one possibility. Adjustments to particular services, clearer contract language, and simpler administrative requirements may also help make an agreement workable.
Psychiatrist and RipsyTech founder Tom Tarshis’s recent experience with Curative offers a useful example. Its AI-assisted contracting process supported a negotiation that produced reasonable reimbursement, revisions to contract terms, and unusually fast credentialing.
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When Negotiations Stall, Look at Individual Services
A negotiation can reach a point where the proposed reimbursement still falls short of what your practice needs. Before deciding whether to proceed, look more closely at how the offer applies to individual services.
Your practice’s financial needs depend on the care you actually provide. The mix of appointments, the resources they require, and how often you deliver them all affect whether a fee schedule supports your budget.
In Tarshis’s negotiation with Curative, the proposed rates had reached an impasse. They were below what his clinic needed to accept the agreement. After pausing the exchange, he proposed a more targeted adjustment: higher reimbursement for a few higher-intensity codes used by his clinic.
Curative agreed. Those adjustments brought the arrangement into line with the clinic’s other higher-paying insurance contracts. The result was fair, workable reimbursement.
For another practice, the useful question is whether specific services could be evaluated individually. A targeted counterproposal gives the contracting team a defined request to consider.
Prepare it around:
The specific codes you want reviewed.
The proposed reimbursement and the amount you are requesting.
The time and resources those services require.
How the revised amounts would fit your practice’s budget.
The aim is to identify an arrangement that supports your actual work. Changing the structure of the request can create another path toward agreement.
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Include Contract Terms in the Negotiation
Once reimbursement looks acceptable, give the rest of the agreement the same attention. Contract language sets expectations for how the relationship will work after you begin seeing patients.
Useful areas to review include:
Termination: Can either party end the agreement, and what notice is required?
Claim submission: How long do you have to submit claims?
Payment: What timeline applies to paying submitted claims?
Disputes and recoupments: How are appeals handled, and when can previously paid amounts be recovered?
Arbitration: Where would a proceeding take place, and could you participate remotely?
The American Academy of Family Physicians’ Family Practice Management article, “Negotiating a Contract With a Health Plan”, provides further guidance on reviewing payment obligations, filing deadlines, termination provisions, and dispute procedures.
These details help you assess whether the agreement fits your practice’s operations. A rate that supports your budget is more useful when the procedures for receiving that payment are clear and manageable.
Tarshis requested roughly eight changes to Curative’s proposed contract. Curative accepted the requests and returned a revised agreement. That willingness to consider the clinic’s needs was an important part of the positive experience.
The practical lesson is to make specific requests about the terms that matter to your practice. Identify the provision, explain your concern, and describe the change you would like considered.
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Use Existing Information to Simplify Credentialing
Credentialing is another part of bringing a new insurance relationship into operation. Keeping provider information current can help the process move forward when the insurer requests it.
In Curative’s onboarding process, Tarshis pointed out that information being requested was already available through his clinicians’ CAQH profiles. Curative adjusted the request so the clinic could supply the additional information needed without repeating the entire submission.
He reported credentialing within about two days, with clinicians whose profiles were current moving through in as little as 24 hours. Where records needed correction, the process continued once those updates were made.
For practice owners, the useful preparation is straightforward: maintain current provider records and ask what information the insurer can already access. Clarify what remains outstanding and how to resolve it.
Curative’s responsiveness made this part of the experience especially positive. It also illustrates the value of an onboarding process that makes use of information clinicians already maintain.
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Evaluate AI Through the Results of the Process
AI-assisted contracting can be evaluated through practical outcomes: whether you receive useful responses, whether your proposals get consideration, and whether the process helps you reach a workable agreement.
In this case, the AI assistance was on Curative’s side. The company described a human network team using AI tools to accelerate drafting, with responses reviewed by the team. Tarshis relied on his own negotiating experience to assess the offers and prepare his requests.
The initial outreach arrived on August 6, and he signed the revised agreement on September 10—a turnaround of about five weeks. That period included rate negotiations, credentialing, and contract revisions.
The value came from being able to move substantive requests through the process. Curative considered a different reimbursement structure, simplified information requests, and responded to proposed contract changes.
For clinicians, that is a promising example of how AI assistance and a responsive contracting team can work together. Your knowledge of the practice still provides the basis for the negotiation.
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Negotiate for an Agreement That Supports Your Practice
A successful insurance negotiation brings several pieces together: reimbursement that fits your services, terms that work for your business, and an administrative process that helps you begin serving members.
Curative’s work with Tarshis shows what can happen when a clinician presents specific requests and the insurer is willing to consider them. The agreement improved through targeted rate adjustments, contract revisions, and efficient onboarding.
Bring that same clarity to your own negotiations. Know which services and provisions matter most, explain what your practice needs, and ask whether a different arrangement could work for both parties.
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.
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