Negotiating with Payers

Earn 1 hour of continuing education by joining OT Potential after taking this course.

Course Description

For many of us, payer negotiations feel distant—something handled “somewhere up the chain,” far removed from the day-to-day work of helping patients. But here’s the truth: nothing shapes our practice more than the reimbursement rates and contracts negotiated on our behalf.

Reimbursement determines who we can serve, how much time we can spend with them, what services we can sustainably provide, and ultimately whether our practice can survive/thrive. And while therapists may assume this is a job for billing or leadership, every OT and PT needs a foundational understanding of how payer negotiations work.

In this one-hour live webinar and podcast course, we’re joined by two leaders with deep, real-world expertise:

• Chad Herzog — VP of Operations at Aroris Health, an organization whose mission is simple and powerful: help healthcare providers get paid what they’re worth so they can focus on what matters most—helping people and improving patients’ lives.
  
• John Hutchinson, MBA — Co-founder of CARE Counseling (with his wife, Dr. Andrea Hutchinson), a practice acquired by UnitedHealth in 2024. John brings firsthand experience navigating growth, payer relationships, and the business realities that shape modern care.

Together, they’ll break down what every clinician should know about payer negotiations, how reimbursement impacts clinical practice, and what therapists can do to advocate for sustainable care models.

Learning Objectives

1.) You will be able to recognize the basic components of payer negotiation for OT.
2.) You will be able to identify the current trends in payer negotiation for OT.

Agenda

Intro (5 minutes)

Discussion (40 minutes)

1. John, can you tell me the story of how payer negotiations became important to you at CARE Counseling?
2. Chad, tell me your story! What drew you to such a specific role?
3. Ok—tell me the basics of payer negotiation. Who talks to whom, and what typically gets decided?
4. Can you share a real example of how a well-negotiated contract improved patient access or clinical outcomes?
5. As OTs and PTs, it feels like we are losing reimbursement battle after reimbursement battle. Why is that?
6. One problem we have is simply scale. Even though we are high impact, we just don’t drive as much revenue as other specialties. And we tend to work in small outpatient practices. What are our options with such a disadvantage?
7. What data matters most in negotiations—clinical outcomes, patient satisfaction, utilization metrics? What should practices be tracking now to strengthen their position?
8. What are the most high-impact things someone like myself at OT Potential—or our state and national associations—can do to support practice owners in this process?
9. What trends do you see on the horizon that we need to pay attention to—things that could either help or hinder this process?
10. For therapists listening today—what’s one shift in mindset that could help them better navigate the realities of reimbursement?

Live Q&A (10 min)

Closing (5 min)

Supporting Research and Journal Articles

• https://www.tandfonline.com/doi/full/10.1080/13696998.2024.2317119
• https://pubmed.ncbi.nlm.nih.gov/26618442/
• https://jamanetwork.com/journals/jama/article-abstract/2820534

Target Audience/Educational Level

Our target audience is occupational therapy practitioners who are looking to learn about Negotiating with Payers. The educational level is introductory.

Financial and Non-financial Disclosures

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

We here at OT Potential have no financial stake in this topic. Our speaker Chad Herzog, works for Aroris Heatlh, which offers services in this space to larger companies. This is disclosed in the episode.

Speakers

Chad Herzog

VP of Operations at Aroris Health, which offers insurance contract negotiation and payer enrollment services. Their mission is simple and powerful: help healthcare providers get paid what they’re worth so they can focus on what matters most—helping people and improving patients’ lives.

John Hutchinson, MBA

Co-founder of CARE Counseling (with his wife, Dr. Andrea Hutchinson), a practice acquired by UnitedHealth in 2024. John brings firsthand experience navigating growth, payer relationships, and the business realities that shape modern care.

Sarah Lyon, OTR/L

Sarah’s passion is helping fellow OT practitioners translate evidence into daily practice. Sarah earned her BA in religion from St. Olaf College, then earned her master’s degree in occupational therapy from New York University in 2011.

Since then, she’s worked in numerous facilities, including a critical access hospital, an acute trauma hospital, and a state inpatient psychiatric hospital. Sarah is the founder/owner of OT Potential. Read more about OT Potential here.

This course was designed to meet your continuing education requirements

We designed the courses in the Club to meet the requirements for “online” and “independent/self-study” courses. To verify the requirements from your specific state (within the US), check out our post, OT Continuing Education Requirements. If you are outside of the United States and have questions, please contact us.

We are proud to be an AOTA Approved Provider and to meet the requirements for your NBCOT renewal.

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