Payer contracting is not easy. Not only do providers need to worry about issues such as varying reimbursement rates, network access and managing hidden clauses, they also need to ensure that they maintain good relationships with the payer when they are negotiating payer contracts. Regardless of practice size, effective healthcare payer contract negotiations are therefore vital to maximize revenue. Our contract review and fee negotiation services are designed to handle the varying goals of both the provider and payer, i.e., providers wanting to deliver quality care to their patients while ensuring business growth and maximized reimbursement against providers wanting to control costs to provide competitive plans to their customers. Our healthcare consultants have the knowledge and skills required to negotiate the terms and conditions of payer contracts to ensure that providers receive the most favorable rates.
Today’s healthcare payer landscape is diverse and complicated, which is resulting in reimbursement challenges for providers. With the advent of bundled payments, value-based contracts and other risk-based models, the only way to achieve financial goals is by negotiating favorable terms with payers. In this changing regulatory environment, complications therefore already exist. But that’s not where it ends. Providers are working with several payers, which means they need to manage several contracts, which could result in additional obstacles such as:
Payor contracting not only requires the understanding of each contract in detail, but also staying ahead of regular cycles of contract negotiation and fee schedule changes. We understand how payers operate and help you build successful payer contracts.
With years of experience and extensive expertise, our advisors are well-versed in contract review services across various payers and specialties. We analyze performance, prioritize frequently billed services, and successfully negotiate favorable contracts for our providers.
We negotiate strong payer contracts, that will not only ensure that providers maximize revenue, but also ensure that they have the necessary resources to deliver high-quality care to their patients.
It’s no secret that negotiating payer contract is a time-consuming process. We handle the paperwork and analyze contracts end-to-end to make the healthcare payer contract negotiations process as seamless as possible for the provider, saving them time and reducing the administrative burden.