$500k
potential revenue recovery
4
new payor contracts negotiated
About the Client
This California-based orthopedic group delivers high-quality, personalized care across multiple clinic locations. With a focus on preventive care, podiatry, and advanced surgical techniques—including joint replacements and soft tissue repairs—the practice is committed to helping patients stay active and pain-free.
Client Need
As the group rapidly expanded across multiple locations, leadership identified a growing need to:
- Address inconsistencies across payor agreements
- Supplement limited internal resources for complex contract negotiations
- Gain visibility into market-level reimbursement trends and rate benchmarks
Prior to working with PayrHealth, contract oversight was managed by a small internal team without dedicated support, leading to missed opportunities for revenue optimization.
PayrHealth’s Solution
PayrHealth implemented a structured, analytics-first strategy to support the client’s growth and financial performance. Key initiatives included:
- Analytics-Driven Negotiation – A custom-built analytics package visualized the financial impact of new and existing contracts, empowering the client to make more informed decisions.
- Market-Driven Proposals – Leveraging market data and CMS benchmarks, PayrHealth created direct rate comparisons across payors, revealing gaps and opportunities.
- Fee Schedule Optimization – PayrHealth uncovered significant underbilling due to outdated charge masters, identifying lost revenue from claims submitted below contracted rates.
- Strategic Positioning – PayrHealth supported the refinement of the client’s letter of intent to clearly communicate their differentiated value to payors.
Client Outcomes
The engagement led to several meaningful improvements:
- Four new payor contracts successfully negotiated
- Implementation of a structured analytics framework to inform future decisions
- Identification of $500K in potential revenue recovery through charge master corrections
Partner with PayrHealth
With over 50,000 contracts negotiated in all 50 states and a team with over 40 years of revenue cycle expertise, PayrHealth helps provider groups secure better contracts, streamline credentialing, and recover lost revenue.
Reach out today to see how we can help your organization grow stronger.
