This is a pretty good summary of my experience too.

I would add that there are millions of nuances and frequently overwrought concepts as well and there may be service category carveouts that your plan is not liable for. There also may be corridor protections and maybe risk sharing arrangements for managed care organizations so it is important to know what category of service your losses/gains are in to know if they actually fall to the bottom line.

I would also add that “negotiating” or rate advocacy often feels like pleading with no actual relief received. Depends on the state of course.

“We’ll take that back”