Strengthen Payer Connections, Negotiate Payer Contracts, and Improve Claims Resolution

Translate providers’ value proposition into market-competitive rates; facilitate out-of-network to in-network conversions; improve positioning for value-based contracting; optimize contracts in joint ventures and acquisitions.

Procure contracts in new markets; penetrate “closed networks;” identify potential in existing markets; incorporate new services into existing network relationships.

Solve systemic claims and credentialing issues; help providers navigate changing policies; build relationships with health plan professionals at all levels.

Improve payer awareness to facilitate inclusion in narrow networks, preferred provider directories, incentive payments, and other payer initiatives; arrange meetings with health plan leadership; maintain warm relationships to ensure timely resolution of issues.

Design and execute against a coherent managed care strategy; reduce A/R, denials, and underpayments; anticipate and manage payer response to growth and innovation; facilitate cross-silo coordination; alleviate administrative burden and abrasion.

Provide insights, news, mentorship, connections, and sharing of best practices; advise confidentially upon request.

Optimize contracts and claims payment after transactions; analyze the contract implications of expansions, joint ventures, investments, and purchases.

Help innovative providers find their place in the health insurance industry and design the services necessary for contracts.