Walk-Away

Demo sample

Price the break-even of dropping a payer — what you'd lose in volume vs what you stop bleeding. So firing a payer stops being a tantrum and becomes a number.

Sample book. Add your NPI to price your real payer contracts.

That's a sample BH group. Drop your NPI to surface the exact parity gaps — your BH codes vs the local-peer median and their medical equivalents — to take into your next rate renegotiation. No PHI, no card.

The decision · Health Net

Paying you 58% of the local-peer median · 9% of your book · $92,000/yr revenue.

first-pass denials ~12.9%appeal window 90d · fast clockDemo benchmarks

MHN (Health Net BH) routes BH through a carve-out that pays ~30% below medical equivalents · tight session caps + frequent re-auth. That spread is your MHPAEA parity lever.

Renegotiation recovery · modeled scenario

Keep as-is

−$47,000

bled per year accepting below-peer rates

Renegotiate to peer

+$35,250

modeled scenario · 75% of documented gap recovered, volume intact

Drop them

−$92,000

revenue forgone — the credible threat

Re-earning the walk takes ~23 months ($92,000/yr forgone vs $47,000/yr bleed). Renegotiation recovers a modeled $35,250 at 75% first. Fire only if they refuse.

Draft the leverage memo

Napkin math: re-earn months = revenue forgone ÷ (annual bleed ÷ 12) · a walk reads credible under 18 months, assuming walked volume refills at peer-median rates · sample figures, modeled, never guaranteed.