Services/Payor Contract Negotiations

Payor Contract Negotiations

We negotiate directly with commercial payors to maximize your reimbursement rates. Most practices are leaving significant revenue on the table in contracts that have never been reviewed.

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Your contracts are probably underperforming

The average independent practice has not reviewed its payor contracts in three or more years. In that time, costs have risen, volumes have changed, and market rates have shifted. The result is that most practices are reimbursed at rates that no longer reflect the value they provide.

We bring data, market intelligence, and negotiation experience to every engagement. Our goal is to increase your rates where the opportunity exists and to ensure your contract terms are fair and enforceable.

Commercial payor contract review and analysis
Rate benchmarking by specialty and geography
Negotiation strategy and preparation
Direct payor negotiation on your behalf
Contract language review and redlining
Post-negotiation implementation and verification

Data-driven approach

We benchmark your current rates against market data before any negotiation begins, so we know exactly where the opportunity is.

Specialty expertise

We understand the procedure codes and reimbursement patterns specific to your specialty, which makes our negotiations more targeted and effective.

Included with RCM

For full RCM clients, contract negotiation support is included. No separate engagement or additional fee required.

Standalone option

If you manage your own billing, we offer contract negotiation as a standalone service. We do the analysis and negotiation; you keep your billing team.

Frequently asked questions

Find out what your contracts are worth

A contract analysis takes less time than you think and often reveals revenue opportunities that pay for themselves many times over.

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