Payor Contracting

Outsource The Administrative Burden

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Payor contracting is rarely transparent, making it difficult for healthcare providers to navigate.  Achieving more favorable contracts requires resources, time, and industry knowledge your team may not have.

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PayrHealth’s Contracting Solutions for Providers

Comprehensive Payor Contract Review

Ensure you are contracted with the right payors and products for your market.

Payor Contract Language Analysis

Contracts are filled with language written by payors’ attorneys that have significant implications for claims adjudication, authorization requirements, etc.  This language can be negotiated.

Utilization-adjusted Free Schedule Analysis

Customized review of your contracted fee schedules based on the codes you bill and how often you bill them.

Increase Reimbursement Rates

It’s important to push for regular rate increases to allow you to keep pace with inflation and to invest in the future.  Knowledge and leverage gives you the ability to negotiate reimbursement rates.

Comprehensive Payor Strategy

Payors think strategically, and you need to as well. The pace of change continues to increase, and providers need to know how to react to changes in the competitive landscape, the regulatory environment, fee schedules, payor products, and value-based care initiatives.

Market Analysis

Understanding the dynamics that drive your market are key to understanding your place in it, and what leverage you can bring to bear.

New Payor Plan Negotiation

The terms of your initial contract with a new payor are critical, as the terms establish a baseline for your participation in that payor’s network, and for subsequent negotiations for rate increases.

What PayrHealth can deliver to your payor contracting

We work with your practice to develop a comprehensive payor contracting strategy. Our approach is collaborative – together we assess where you stand in the market, identify your strengths and leverage opportunities and show you how to use them.

Contract New Payors, New Networks, and New Products

Negotiate more successfully and take advantage of new opportunities

Contract Renegotiations

Rely on healthcare industry experts and experienced negotiators.

Contract Management

Free up valuable team members by offloading time-consuming payor contract management, and benefit from process transparency with regular updates.

PayrHealth supports multiple provider types:

  • Primary Care and Specialist Physicians
    - Solo practice
    - Group practice
    - Multi-specialty practice
  • Behavioral Health Providers
  • PT/OT/SLP
  • Hospitals
  • ASC's
  • Integrated Delivery Systems
  • IPA/PHO
  • MSO
  • ACO

When working with PayrHealth, you’ll get the following and more:

The contracting process is designed by payors to be lengthy, challenging, and opaque. Navigating these barriers requires perseverance, and benefits from inside knowledge of payor operations, motivations, and strategies.

We integrate as a department of your practice

PayrHealth eliminates the need to the add permanent overhead costs of hiring and maintaining a full-time staff of contract negotiators, managed care analysts, and contract managers to your practice. Our team will perform all of these functions, as an extension of your practice and in concert with your staff, but only when you need it.

30+

years in business

50

States Experience

7,000+

Payor Contracts

50,000+

Contracts negotiated

By the numbers with PayrHealth

Our success is recognized across the healthcare industry. Hear from real organizations and healthcare providers of all sizes to learn how we made substantial changes to their practice revenue – and how specifically we can help you.

About PayrHealth