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Your compensation depends as much on your practice's ability to get reimbursed by payers as it does on your skill with patients. Contracting with all payers may seem like a solution, but that wouldn't be business-savvy; however, neither is getting under-reimbursed for too many out-of-network claims. Operating out of network (i.e., without a payer contract) means that for many services, you will be flying without the reimbursement safety net of a contract, and you may have trouble getting paid. This out-of-network collection struggle happens for several reasons