Payor contracting for ambulatory surgery centers, from the first contract to the renegotiation
PayrHealth negotiates ASC payor contracts and enrolls new centers and their surgeons: case rates, implant and multi-procedure terms, out-of-network strategy, and the credentialing that lets a new center bill from its first case. For independent, physician-owned and private equity-backed surgery centers in all 50 states, since 1994.
Founded in 1994 as Healthcents, PayrHealth since 2021. Contracting, credentialing and revenue cycle for surgery centers under one roof.
What we do for surgery centers
Everything an ASC needs from its payors, handled by one team: the facility contracts, the surgeon enrollments, the new-center launch and the follow-up when a payor pays wrong.
Complete payor management runs contracting, credentialing and facility billing together, including denials and complex claims; revenue cycle management is also available on its own.
Opening or acquiring a center? See if you qualify for a free rate review and we will show you where your rates sit against your market.
How an ASC engagement works
Your first year with PayrHealth, from contract inventory to a negotiation plan that renews every year. Progress is visible in your portal and in scheduled reviews.
Onboarding
Month 1Contracts, fee schedules, case mix and implant spend collected through paperless intake, and your dedicated team meets your administrator and owners.
Strategy
Months 1–2Every contract modeled against market data for your case mix, including case rates and implant terms, targets ranked by revenue and negotiating position, and the year's calendar set.
Negotiation and enrollment
Months 2–8Priority payors renegotiated and new contracts pursued, while new surgeons, service lines and locations are enrolled in parallel.
Growth
Month 8 onwardNew rates loaded and verified on the payor's side, next-tier payors opened, and new service lines and centers added to the plan.
Reporting and follow-up
ThroughoutUnderpayments and payor issues worked as they arise, with every contract, rate and application in your portal and regular reviews with your team.
A typical first year. Payors set their own pace on each contract; renegotiated rates typically take effect 8 to 12 months after kickoff.
Surgery center results
in added revenue in a single year, from double-digit increases on the center's top three revenue-producing contracts
rate increases across the center's largest payors, worth $235,675 in year one, with the affiliated clinic negotiated alongside
payor contracts secured and 3M+ new covered lives as the center added service lines and locations, a client since 2018
Services for surgery centers
Take one service or run them together. Surgery centers that want one team for all of it choose complete payor management.
Payor contracting
Case rates, implant terms and new network access, negotiated from market data
Credentialing
Facility enrollment for new centers and surgeon credentialing with every payor
Complete payor management
Contracting, credentialing and revenue cycle, including denials and complex claims, by one team on one fee
Revenue cycle management
Facility billing, 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
ASC contracting questions
How are ASC payor contracts different from physician contracts?
Surgery centers are paid facility fees, usually grouper-based case rates or a percentage of a fee schedule, with separate terms for implants, high-cost drugs and multiple procedures. Those terms often move revenue more than the base rate, which is why we negotiate them specifically.
Can you benchmark our case rates?
Yes. Each contract is modeled against the best-paid quarter of surgery centers like yours, for the same codes, in your market, so the negotiation starts from what the market actually pays.
We are opening a new ASC. When should contracting start?
As soon as the entity, NPI and projected opening date exist, ideally six to nine months before the first case. Medicare certification, state Medicaid enrollment and commercial contracts run on different clocks, and starting early is what lets a new center bill from day one.
Do you handle implant carve-outs and multi-procedure discounts?
Yes. Implant and high-cost supply reimbursement, multiple-procedure reduction rules, grouper assignments and escalators are on the table in every ASC negotiation.
What about out-of-network?
We model in-network and out-of-network revenue by payor and recommend the strategy that pays, and we support out-of-network reimbursement where in-network terms do not make sense for a service line.
Do you credential our surgeons too?
Yes. Surgeons, anesthesiologists and CRNAs are enrolled under the right entities with every payor the center contracts with, and kept enrolled through recredentialing and revalidations.
We are private equity-backed with several centers. Can you work across the platform?
Yes. Portfolio-wide contract inventories, consistent terms across centers, changes of ownership on acquisitions and new-center launches are handled by one team, with reporting at the platform and center level.
How do you report progress?
Through the client portal, which shows every contract, negotiation and application and its status, plus scheduled reviews with your administrator and owners.
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 center, your case mix and your top payors. If you qualify, we show you where your contracts sit against the best-paid quarter of surgery centers like yours, for the same codes, in your market, 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.
