Payor Contracting Services
We have proven experience and expertise in the industry negotiating higher-than-standard rates with commercial payors to yield additional revenue.
Payor Contracting Services
We provide a suite of services that helps organizations create effective payor strategies, develop more favorable reimbursement rates and contract terms, and enhance their ability to maximize traditional and non-traditional payment arrangements.
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Proven Experience And Expertise In The Industry
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We have demonstrated expertise in negotiating higher-than-standard rates with commercial payors to yield additional revenue. We can also create effective, ongoing education for providers and business staff.
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Multiple Reimbursement Methodologies, Alternative Payment Models, And Non-Traditional Payment Arrangements
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Contracting using a variety of reimbursement methodologies, from fee-for-service to bundles to case rates. We specialize in developing relationships with outside providers or other organizations to effectively partner in alternative payment models and risk-based arrangements. We also have experience building unique programs with TPAs and self-funded employer groups to increase direct referral sources.
Standard Payor Services
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Evaluate Contract Terms & Policies
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Review Reimbursement Status
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Provide Coaching On Negotiations
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Analyze Claims Data
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Market Your Services
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Develop A Strategy
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Create A Plan
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Assess Your Readiness
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Determine The Impact
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Provide Ongoing Coaching
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Conduct A Market Review
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Build Stronger Relationships
Evaluate current contract language to identify problematic policies and/or terms for one or all contracts in place
Review current reimbursement status with respect to financial goals/needs, payments/revenue, volume, and market leverage
Provide coaching on approaches for payor negotiation success
Identify opportunities for increases through claims analysis and reporting
Create strategies for promoting specific service lines or procedures with carriers or purchasers
Develop a payor contracting strategy to align with desired objectives
Create a plan for maximizing reimbursement opportunities, including alternate payment methodologies such as carve-outs/case rates, risk-based, or purchaser-direct
Assess readiness for bundled payments, including potential opportunities for partnering with other local providers
Provide insight into potential operational impacts of risk-based or bundled arrangements
Deliver ongoing coaching & education to providers and other staff regarding the benefits, implications, and risk mitigation for non-FFS payment model
Conduct a market review and identify opportunities to capitalize on unique offerings
Develop outreach approaches for fostering stronger relationships with carriers and provider networks
GAIN THE INTELLIGENCE YOU NEED TO
improve your payor contracting strategies