About the Client

Priority Hospital Group is a multi-state post-acute care provider operating long-term acute care hospitals (LTACHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs) across Texas, Arkansas, Louisiana, and Alabama, delivering specialized care for medically complex patients.

Client Need

• Site neutral payment policies delaying or underpaying claims
• Outdated legacy payor agreements requiring renegotiation
• Credentialing gaps from ownership and location changes
• Limited payor engagement, including resistance to renegotiation and network expansion

Reimbursement had not been updated in years and sat below market. The largest commercial payor had not issued a meaningful rate update since 2016.

PayrHealth's Solution

PayrHealth worked across contracting, claims, and credentialing:

Targeted Claims Resolution. Led ongoing JOC meetings to resolve site neutral payment discrepancies claim by claim.

Credentialing and Enrollment Alignment. Updated provider records for new ownership and locations in payor systems.

Financial and Operational Alignment. Used benchmarking and transparency data to renegotiate legacy agreements and expand access.

Strategic Contracting and Network Expansion. Worked with the client’s CFO to aligncontracting with operational priorities.

Key Takeaway:

Through a coordinated approach spanning claims resolution, credentialing, and strategic contracting, PayrHealth helped PriorityHospital Group stabilize revenue following acquisition and build a scalable foundation for continued growth.

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