When “No” Is Just the Beginning: Turning Payor Denials into Contracts That Work

By Scott Dewey, Chief Managed Care Officer

If you’ve ever tried to join a payor’s network, you know the frustration: you gather the data, demonstrate your quality outcomes, showcase your cost efficiency, and instead of a contract, you get a flat “no.”

Here’s the truth: in most cases, that “no” doesn’t mean the door is closed. It means the negotiation is just beginning.

At PayrHealth, we’ve seen this pattern across specialties, geographies, and payors. The first denial is often a test of persistence, a way for payors to gauge whether providers will walk away quietly or come back with a stronger case. The providers who succeed are the ones who treat “no” as the opening move, not the end of the game.

Three Key Steps to Push Through a Payor Denial

1. Lead with data

Facts carry more weight than frustration. Bring hard evidence to the table: risk-adjusted outcomes, PMPM or PMPY cost comparisons, patient access data, and quality benchmarks. Frame your practice not just as a clinical asset, but as a financial advantage to the plan. When you can demonstrate that excluding you costs the payor more in the long run, you shift the burden of proof back onto them.

2. Escalate effectively

The first “no” usually comes from someone with limited decision-making authority. Don’t stop there. Successful providers create a structured escalation path: moving from regional representatives to contracting managers, to directors, and in some cases, all the way up to medical economics teams or network strategy executives. Each layer requires clear documentation, consistent messaging, and a willingness to keep the conversation alive until you reach the true decision makers.

3. Stay firm and patient

Payor negotiations are rarely quick. They can take months or longer. The key is persistence without hostility. Reiterate your value, follow up consistently, and don’t let silence be the final answer. A professional but firm approach signals that you’re not going away and that you understand the business dynamics as well as they do.

Turning “No” into Opportunity

We work with providers every day who come to us after hearing “no” for months, sometimes years. With the right data, the right escalation strategy, and the right persistence, those denials become contracts, often with terms stronger than what was originally on the table.

At PayrHealth, our mission is simple: turn rejection into contracts, lost revenue into recovery, and barriers into breakthroughs. Because for providers who deliver quality, efficient care, “no” should never be the final answer.

Contact us today to learn more about how you can turn a payor’s “no” into a lasting contract that works for both your practice and your patients.

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