Payor Contract Management

Payor contracts are crucial to being compensated for your work and as the rules of the game change, you need experts to help you stay on top of the dynamic regulatory environment. Whether it is traditional fee-for-service contracting, capitation arrangements, Independent Physician Association (IPA) or Clinically Integrated Network (CIN) agreements, you need an expert looking out for your practice’s interests. Other critical areas include:

• Evaluating a client’s position in the market to create a strategic plan that differentiates them from the competition.
• Working with a third-party payer on a contract rate or payment dispute.
• Preparing a Payor Contract Matrix of all contract rates and key terms.
• Conducting payment compliance audits to ensure that all items and all CPT codes are being paid accurately to your practice.