The more insurance contracts a physician carries, the more personnel it takes to process the information and paperwork (yes, even in the electronic age). Each has different idiosyncrasies about billing and the codes to be used, about referrals and how they work, and different formularies of "preferred" medications.  

A guiding principle in a small business of any kind, especially a medical practice, is to Keep It Simple. In order to maintain lower fees and lower overhead, I decided to have a contract with only Premera and Regence PPO.