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Communication and Personality in Negotiation

Carletta Whiting
MKT/445
September 19, 2011
Kerri Walsh






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Communication and Personality in Negotiation
A negotiation is a method involving two groups in talks to Iind an amicable resolution
around a diIIicult issue. The negotiation I took place in happened to resolve an ongoing problem
with an insurance company. The insurance company Iailed to reimburse the organization Ior
dialysis services rendered to patients according to the rates speciIied in the insurances Iederal
beneIits summary plan description Ior Iacilities considered an out-oI-network provider. This
dissertation will evaluate the roles oI communication and personality in negotiation and how
they contributed to or detracted Irom the negotiation.
When communicating with others it is important to identiIy each side participating in the
negotiation process has a personality. Acknowledging the diIIerences in individual personalities
and the ability to determine the appropriate personality to use during the negotiation process to
achieve the best outcome Ior everyone is important. When dealing with individuals on an
ongoing basis it is helpIul because one has an opportunity to become Iamiliar with their
opponent enough to know the type oI personality he or she is dealing.
The dialysis company rendered dialysis services to a number oI patients` and billed his
and her insurance carrier only to receive payments based on a contracted rate, which was agreed
upon by both parties Ior the PPO, Indemnity, and POS products instead oI at 65 oI Iull billed
charges. As a representative oI the organizations billing department the appropriate number oI
appeals were sent to the insurance company only to receive the same response stating the claims
were processed correctly and no additional payment would be issued. It was later brought to the
organizations attention that several patients` accounts were underpaid and appealed with no
additional payments issued to the sum oI approximately $500K.

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The organization typically uses negotiations to come to an agreement on contract rates,
short-term payment agreements, and reimbursement oI out-oI-network reimbursements Ior
services rendered in regard to a liIe sustaining condition. The director oI billing decided to
attempt using the negotiation process with the insurance carrier beIore resorting to legal actions.
Setting up a conIerence call between the director, manager, supervisor, and representative oI the
organization`s billing department, and the claims director, manager oI the insurance company to
discuss the processing oI the previous underpaid claims. During the phone communications
discussions transpired back and Iorth expressing the issue. The communication process also
involved an explanation to the insurance carrier inIorming them the only way a contracted rate
can be used is there must be a signed contract on Iile Ior each product line. Out-oI-network
claims should not be paid according to the insurance companies contracted rates whenever
possible.
As the billing representative assigned to work the insurance plan, I was responsible to
compile data to include patients` id numbers, dates-oI-services, charges, receipts, and balances
due Ior the conIerence call. 'It is widely assumed that successIul negotiators are planIul,
attentive, organized, and have high aspirations the very characteristics one might expect Irom a
person high in the personality trait oI conscientiousness (Lewicki, Saunders, Barry, 2005, p.
397). During the negotiations the billing manager was direct during the discussion process
although at times it caused the insurance representative to become deIensive. 'A greater risk Ior
extroverted and agreeable negotiators because oI their greater Iocus on the maintenance oI social
relations. Negotiators with a high degree oI motivation to do well overcame the liability oI
certain personality traits in negotiations (Lewicki, Saunders, Barry, 2005, p. 397).

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When conducting negotiations over the phone it is vital Ior all parties to watch the tone in
his or her voice to prevent oIIending the other party. The billing manager`s extroversion
personality hindered the discussions by oIIending the insurance representative and causing the
discussion to be sidetracked to clear up any misunderstandings perceived by the opposing side.
'The activity oI having or managing a conIlict occurs through communication. More
speciIically, communication undergirds the setting and reIraming oI goals; the deIining and
narrowing oI conIlict issues; the developing oI relationships between disputants and among
constituents; the selecting and implementing oI strategies and tactics; the generating, attacking,
and deIending oI alternative solutions; and the reaching and conIirming oI agreements (Putnam
and Poole, p. 550).
Negotiations are simply the process oI communication and making sure each side
identiIies a way to agree to a solution which everyone wins in the end. Working with the
insurance carrier Ior two hours it was determined the claims were processed according to a
contract Ior the Federal policies. The organizations contracts department sat in on the call, and it
was determined the contract was no longer valid; thereIore, the insurance company updated their
systems and the claims representative would review the previously processed claims Ior
additional payment to be received within 30 days Irom the call. Both parties acknowledged their
part in the miscommunication in regard to the contract. The insurance company assured the
billing manager the situation would be resolved and would not happen in the Iuture. A
suggestion was made to have every contract reviewed on both sides to ensure there is no other
contract`s that should be terminated but are still eIIective in the establishments systems.
Resolving this issue with the insurance carrier within a timely manner assists helps the
organization to decrease the days sales outstanding (DSO). 'Days sales outstanding are a

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calculation used by a company to estimate their average collection period. A low number oI days
indicate the company collects its outstanding receivables quickly
(http://encyclopedia.theIreedictionary.com).
Conclusion
In conclusion, decreasing conIlict during the negotiation process is imperative;
participants must work together to a Iind solution beneIicial to all. Establishments negotiating
claim payment rates with an insurance company is a winning solution Ior organization rendering
liIe sustaining services to individuals with end stage renal disease. The contracting department
typically negotiates contract pricing with insurance carries; however, when there is a Iacility
considered out-oI-network the negotiator is the billing director, billing manager, and billing
representative. A number oI people may start the negotiation process with their own issues on his
or her mind. Whereas, organizations go into the negotiation process only seeking their own
organizational success. An establishment can maintain success in the Iuture; discussions are an
important device to retain proIitable. EIIective negotiations depend on the communique among
the participants, and bargaining`s aIIected by the temperament oI everyone involved.







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ReIerences
Days Sales Outstanding, Retrieved September 19, 2011 Irom
http://encyclopedia.theIreedictionary.com/DaysSalesOutstanding
Putnam and Poole, (1987), The Nature oI Communication in Negotiations p. 550.
Lewicki, Saunders, Barry, (2005), Negotiation, IiIth edition The 'Big Five Personality Factors
(p. 397).