Payor contracting for ancillary providers, including the networks that say they are closed
DME and HME suppliers, laboratories, imaging centers, home health and hospice agencies, infusion, therapy and post-acute providers hear the same thing from payors: the network is adequate. PayrHealth builds the case for getting ancillary providers in, negotiates the rates once they are, and enrolls every location and NPI so the contract can be billed. In all 50 states, since 1994.
Founded in 1994 as Healthcents, PayrHealth since 2021. Contracting, credentialing and revenue cycle for ancillary providers under one roof.
What we do for ancillary providers
Network access, rates, enrollment and follow-up, handled by a team that works ancillary contracts every day and knows which payors close their networks and how to reopen them.
Suppliers with many locations usually run this as complete payor management; payor contracting and credentialing are also available on their own. Surgery centers have their own page.
See if you qualify for a free rate review and we will show you where your contracts sit against your market and which networks are open to you.
How an ancillary engagement works
Your first year with PayrHealth, from contract inventory to a network plan that renews every year, with progress in your portal and scheduled reviews with your team.
Onboarding
Month 1Contracts, fee schedules, locations, accreditations and payor correspondence collected through paperless intake, and your dedicated team meets yours.
Strategy
Months 1–2Your value case written for payors, targets ranked by covered lives and revenue at stake, and existing rates modeled against your market.
Network requests and negotiation
Months 2–8Join-the-network requests, reconsiderations and escalations worked with each payor, existing contracts renegotiated, and locations enrolled in parallel.
Growth
Month 8 onwardNew agreements loaded and verified, the next states and payors opened, and new product lines or locations added to the plan.
Reporting and follow-up
ThroughoutUnderpayments, network notices and payor issues worked as they arise, with every contract and application in your portal and regular reviews with your team.
A typical first year. Closed-network requests can take longer than renegotiations; see the FAQ for what to expect.
Ancillary provider results
contracts in 19 new states for a CPAP and BiPAP supplier, opening access to 30M+ new patients, including networks previously called closed
on commercial claims, against an industry norm near 60%, after PayrHealth overturned a national payor's denial in a lab network that stayed closed to most applicants
covered lives reached through a new Missouri commercial agreement, from a baseline of no contract and a closed DME network
Services for ancillary providers
Take one service or run them together. Multi-location suppliers usually choose complete payor management.
Payor contracting
Closed networks reopened, new agreements secured and existing rates renegotiated
Credentialing
Location and supplier enrollment, Medicare DMEPOS and state Medicaid, kept current
Complete payor management
Contracting, credentialing and revenue cycle, including denials and complex claims, by one team on one fee
Revenue cycle management
Claims, denials and payor follow-up, with every remittance checked against the contract
What clients say
“They use rigorous data analysis as the basis for developing a solid negotiating approach.”
Leland Tong, MD · Google review
“We highly recommend their services to any healthcare provider looking to optimize their revenue.”
Dr. Rajesh Gupta, Medical Director, AFC of Yorktown
“They will take the time to help you figure out what you need and then work with you to achieve it.”
David Siegel · Google review
“They are very easy to work with and incredibly responsive when we have questions.”
Brandi Garlutzo · Google review
Ancillary contracting questions
Which ancillary providers do you work with?
DME and HME suppliers, laboratories, imaging centers, home health and hospice agencies, infusion, physical and occupational therapy, skilled nursing and other post-acute facilities, and specialty suppliers such as orthotics and retail eyewear. Surgery centers have their own page.
The payor told us the network is closed. Can you still get us in?
Often, though not always. A closed network reopens when the payor sees a need: a specialty, a geography, a service its current providers do not cover. We write that case, request reconsideration on the denial and escalate to network leadership, and we tell you up front where the odds are poor.
Do you handle Medicare DMEPOS and state Medicaid enrollment?
Yes. Supplier enrollment with Medicare, including DMEPOS, state Medicaid programs and managed Medicaid plans is handled location by location, along with revalidations and changes of ownership.
We operate in many states. Can you contract across all of them?
Yes. Targets are ranked by covered lives and revenue at stake in each state, and every location and NPI is enrolled so the agreement can be billed.
Can you improve the rates we already have?
Usually. Existing agreements are modeled against your market and renegotiated with the payor, including fee schedule structure, escalators and the terms that decide what a rate is actually worth.
What happens when a payor terminates us for network narrowing?
We respond before the termination date with the value case for keeping you in network and negotiate the terms of staying in. Where that fails, we pursue the alternatives that keep patients covered.
How long does network access take?
New rates typically take effect 8 to 12 months after kickoff, depending on the payor and the contract's renewal terms. Closed-network requests can take longer, because reconsiderations and escalations add rounds, and some payors review network adequacy only on a schedule.
How do you report progress?
Through the client portal, which shows every contract, network request and application and its status, plus scheduled reviews with your team.
How do I get started?
See if you qualify for a free rate review using the form below. If you qualify, we show you where your contracts sit against your market and come back with a plan and a quote.
See if you qualify for a free rate review
Tell us about your organization, your product or service lines and the payors you need. If you qualify, we show you where your contracts sit against your market, which networks are open to you, and come back with a plan and a quote. No obligation.
After you submit, practices that qualify pick a time with our team on the next screen.
