Payer Contracts

 

Negotiating payer contracts is complex, and intensely data driven. Physician Practice Guidance cuts through the complexity and builds the practice’s case for higher reimbursement rates using regional and national data. Additionally, Physician Practice Guidance offers strategies for increasing reimbursement rates by expanding service lines. Physician Practice Guidance has demonstrated record for achieving higher reimbursement rates for all practices, but especially small and medium size practices.

 

Higher contract reimbursement rates equal higher revenue.

Our services include

Commercial and Government sponsored plans (Medicare Advantage)

 

Marshaling data to support negotiation position

• Cost per RVU
• historical performance
• national and regional data to benchmark practice performance
• market share
• patient demographics
• negotiated rates received by other payers in the practice’s specialty
• quality metrics
• breakout of risk adjustment code volume
  

Negotiating provisions of the written payer contract

Follow up to continuously review and negotiate payer rates

 

We support the outpatient office based physicians of all specialties and services
Group practices and solo practitioners:

• ACOs
• IPAs
• Specialty networks