Guide

The 90-day exit: termination clauses read both ways

Summary

A without-cause termination clause lets either party end a payer contract for any reason by giving written notice — commonly 60 to 90 days, but your contract controls the exact period. It reads both ways: the payer can drop you on the same terms you can drop it. Give or receive notice in writing to the address in the contract, track the delivery, calendar the effective date, and plan for continuity-of-care obligations that outlast the contract.

By Gale Editorial · Updated 2026-07-26. Every figure cited to a dated source. How we write.

What without-cause termination is

A without-cause termination clause lets either party end the contract for any reason — or no stated reason — by giving advance written notice. The notice period is commonly 60 to 90 days, but the exact number is in your contract and your contract controls; do not assume a figure you read on someone else's agreement. The clause is symmetric on its face: the same period that lets you leave is the period on which the payer can drop you.

That symmetry is the reason to treat reading a payer contract as a two-directional exercise before signing. A short without-cause period cuts both ways — easy for you to exit, easy for the payer to exit you, which matters more when a single plan is a large share of your panel. Distinguish it from termination for cause, which is triggered by a defined breach and usually carries a cure period; without-cause needs no reason and no cure, only notice given the right way.

Giving or receiving notice so it actually takes effect

Giving or receiving notice correctly is what makes the termination effective on the date you expect. Send written notice to the exact person and address named in the contract's notice clause, use a delivery method you can track, and count the notice period from the date of receipt as the contract defines it. The effective date is the end of that period, not the day you mailed the letter.

The specific notice period, the required address, and any portal step are the payer's own and live in its contract and published provider manual — Anthem 1 and Cigna 2 each publish provider materials where these mechanics are documented, and the version in force governs. Keep amendment-by-notice in mind while you are there: many payer contracts let the plan change terms by sending notice, so the same mechanism you use to exit is the one the plan uses to alter the deal. Read the notice clause and the amendment clause together, not separately.

When the payer terminates you

When a without-cause termination arrives from the payer, the clock is the notice period and your first job is to protect patients and cash. Confirm the effective date in writing, identify which of your patients are members of that plan, and check the contract for continuity-of-care language — many contracts and several state rules require you to keep treating members in active treatment for a transition period at contract rates, though the specifics are a common variable rather than a universal rule.

Then work the exit accounting. Read the audit and lookback clauses to see how long after termination the payer can still review paid claims and demand overpayments, because that window usually survives the contract. If a dispute over a takeback or a final payment looks likely, the dispute resolution clause tells you the forum and the deadline. Contract disclosure clauses may also require you to notify the payer of the change, so confirm what you owe the plan on the way out rather than discovering it later.

When you terminate the payer

When you are the one leaving, give notice deliberately and run out the runway. Send proper written notice, calendar the effective date, and keep serving that plan's members cleanly through the period so no claim you file afterward is contested. Plan your panel around the gap: if the plan is a meaningful share of your revenue, line up the replacement volume before you send the letter, not after.

Tell affected patients early and in writing that you will be out of network as of the effective date, and explain their options — transferring care, continuing with you out of network, or requesting continuity of care from the plan. Update your public listings and your intake process so you are not booking that plan's members into visits that will not be covered. A clean, well-noticed exit is the difference between leaving a network and leaving money on the table.

Coming back is re-credentialing, not a light switch

Leaving a network is not a pause you can un-press; coming back means credentialing again. Health plans follow standards under which licensure and history are primary-source verified, a National Practitioner Data Bank query is run, verifications age out after a set window, and clinicians are recredentialed at least every 36 months 3. A provider who terminates and later reapplies re-enters that process largely from the start, on the weeks-to-months timeline credentialing always takes.

That lag is a reason to think twice before a without-cause exit from a plan you may want back. If the real issue is a rate or a single disputed term, a renegotiation or a formal dispute may serve you better than termination. Weigh the exit against the cost of the return, and keep your credentialing profile current in the interim so re-entry is not slower than it has to be.

The exit admin when a contract ends

A contract ending triggers a short list of administrative updates that are easy to forget and expensive to skip. If your practice information changes as part of the exit — address, group affiliation, a reassignment of benefits — the change has to flow to the registries and programs that hold your data, each on its own clock.

WhereWhat to doTiming
NPPESUpdate the NPI record if your practice information changesWithin 30 days of the change
MedicareMake enrollment and reassignment changes in PECOSWhen the change takes effect
MedicaidHandle disenrollment through your state's Medicaid programPer the state agency's rule

Updates to your NPI record are made free of charge through NPPES, and the record must be kept current within 30 days of a change 4. Medicare enrollment changes — including ending a reassignment of benefits — are transacted in PECOS 5. Medicaid is state-administered, so any disenrollment or change runs through your state's Medicaid agency rather than a national system 6. Fold these into your exit checklist so a terminated contract does not leave a stale record behind it.

Common questions

It means either party can end the contract for any reason, or no stated reason, by giving advance written notice — commonly 60 to 90 days, though your contract sets the exact figure. It differs from termination for cause, which requires a defined breach and often a chance to cure. Because the clause is symmetric, the same notice period that lets you leave is the one the payer can use to drop you.

Send written notice to the exact person and address named in the contract's notice clause, using a delivery method you can track. Count the notice period as the contract defines it, and treat the effective date as the end of that period rather than the day you sent the letter. Keep a copy of the notice and the delivery confirmation with your contract file in case the date is later disputed.

Under a without-cause clause, yes — the same clause that lets you exit lets the payer exit you, on the notice period the contract specifies. What the payer cannot do is skip the notice or ignore continuity-of-care obligations the contract or state law imposes for members in active treatment. If a termination looks like it violates the contract's own terms, the dispute resolution clause tells you the forum and the deadline to challenge it.

Often for a transition period. Many contracts, and several state rules, require a terminating provider to continue treating members in active treatment for a defined window at contract rates, so patients are not stranded mid-care. The specifics vary by contract and state, so read your continuity-of-care language and check your state's rule. Plan the exit so those obligations are met before you fully disengage from the plan.

Not quickly. Rejoining means credentialing again — primary-source verification of your license and history, a National Practitioner Data Bank query, and the plan's standard recredentialing process, which runs on the same weeks-to-months timeline as the first time. Keep your credentialing profile current in the meantime so re-entry is not slower than necessary, and weigh that lag before terminating a plan you may want back.

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References

  1. 1.Anthem (2026). Anthem Provider Policies. Anthem provider portal. linkNamed example that a national commercial payer publishes its provider materials online, where the specific termination notice mechanics for its contracts are documented.
  2. 2.Cigna (2026). Cigna Coverage and Claims Policies. Cigna provider portal. linkNamed example that Cigna publishes its provider policies online, so the notice and process details that govern a termination are the payer's own published materials.
  3. 3.National Committee for Quality Assurance (2026). Credentialing — NCQA. National Committee for Quality Assurance (NCQA). linkThat plans primary-source verify licensure and history, run an NPDB query, age out verifications, and recredential at least every 36 months — the reason re-entering a network after termination is a full credentialing cycle, not instant.
  4. 4.Centers for Medicare & Medicaid Services (2026). National Plan and Provider Enumeration System (NPPES). Centers for Medicare & Medicaid Services (CMS). linkThat NPI records are updated free of charge through NPPES and must be kept current within 30 days of a change — the exit-admin duty when practice information changes.
  5. 5.Centers for Medicare & Medicaid Services (2026). Medicare PECOS. Centers for Medicare & Medicaid Services (CMS). linkThat Medicare enrollment changes, including ending a reassignment of benefits, are transacted in PECOS — the Medicare-side update when a contract ends.
  6. 6.Centers for Medicare & Medicaid Services (2026). Provider Enrollment. Medicaid.gov. linkThat Medicaid provider enrollment is state-administered, so any disenrollment or change runs through the state agency rather than a national system.

https://www.gale.care/for-providers/ct-termination-without-cause-90day · 6 sources. Competitor details are cited to dated public sources and maintained as they change; figures are estimates, not commitments. Synthetic demonstration.

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