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Single Case Agreement (SCA) Negotiation Services

Need to treat an out-of-network patient without losing clinical revenue? We negotiate custom Single Case Agreements with insurance carriers to secure your in-network billing rates.

Negotiate Your SCA Now
Patient Access

Secure Out-of-Network Coverage Fast

A Single Case Agreement (SCA) is a contract between an out-of-network provider and an insurance company to cover a specific patient at in-network rates. Without it, patients face prohibitive out-of-pocket costs, and providers risk unbillable sessions.

EXP handles the entire SCA negotiation workflow, securing approvals from major carriers in hours instead of weeks. We specialize in proving:

Continuity of Care — Retaining treatment for patients transitioning to a new plan or recovering from major clinical episodes.
Specialized Treatment Shortage — Demonstrating that in-network alternatives lack the specialized certifications (e.g. ABA center models, PMHNP pediatric care) required by the patient.
Geography-Based Exceptions — Proving that no in-network specialists are available within a reasonable distance (typically 30 miles or 30 minutes).
Flat-Rate SCA Negotiations

Securing SCAs manually requires hours of calling, follow-up, and contract drafting. We handle the entire process from start to signature for a transparent, flat fee.

$350
Per Executed Agreement · No Hidden Fees
Payer Outreach

The SCA Negotiation Workflow

1

Documentation Audit

We collect the patient's medical records, referrals, and clinical justification details.

2

Proposal Formulation

We compile a formal SCA request detailing the CPT codes and in-network rate justifications.

3

Payer Negotiations

We negotiate terms directly with the payer's out-of-network contracting coordinators.

4

Contract Execution

We review the finalized agreement to verify billing codes and secure signatures.

Frequently Asked Questions

When should a provider request a Single Case Agreement?

SCAs are requested when an out-of-network provider needs to start or continue treatment for a patient whose plan lacks equivalent in-network specialists within their geographic region.

What billing rates can be secured under an SCA?

We target the patient's in-network rate or negotiate a custom percentage of the plan's standard fee schedule, protecting your practice revenue.

Do you charge if the SCA negotiation is unsuccessful?

Our $350 fee is flat and only applies to successfully executed agreements. If the payer refuses to approve the SCA, you don't pay us.

Treat Your Out-of-Network Patients Stress-Free

We handle the administrative negotiation and paperwork for a clean, flat fee.

Negotiate an SCA Today