Payor contracting for hospitals and health systems that need a managed care department without the headcount
PayrHealth negotiates hospital payor contracts, inpatient and outpatient, credentials employed clinicians and facilities, and works the site-neutral payment, underpayment and contract loading problems that eat into reimbursement. For community, independent and post-acute hospitals and small health systems in all 50 states, since 1994.
Founded in 1994 as Healthcents, PayrHealth since 2021. Contracting, credentialing and revenue cycle for hospitals under one roof.
What we do for hospitals and health systems
The work a managed care department does, delivered by a dedicated team: contract negotiation, employed-provider and facility credentialing, payor issue resolution and reporting your CFO can act on.
Hospitals that want the whole job done usually run this as complete payor management; payor contracting and credentialing are also available on their own.
See if you qualify for a free rate review and we will show you where your hospital's contracts sit against your market.
How a hospital engagement works
Your first year with PayrHealth, from contract inventory to a negotiation plan that renews every year, with progress in your portal and scheduled reviews with your CFO.
Onboarding
Month 1Contracts, fee schedules, case mix and payor correspondence collected through paperless intake, and your dedicated team meets your CFO and managed care lead.
Strategy
Months 1–2Every agreement modeled against market data by service line, targets ranked by net revenue and negotiating position, and credentialing gaps closed first.
Negotiation and enrollment
Months 2–8Priority payors renegotiated and new agreements pursued, while employed clinicians 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 locations added to the plan.
Reporting and follow-up
ThroughoutSite-neutral payment, underpayment and loading issues worked as they arise, with every contract and application in your portal and regular reviews with your team.
A typical first year. Payors set their own pace on each contract; see the FAQ for what to expect.
Hospital results
increase on select high-volume outpatient services over three years, and 14.5% on inpatient MS-DRG rates, after a key contract was saved from termination
recovered in claims tied to site-neutral payment, plus 10 to 22% rate increases across multiple payors after an acquisition
Medicare, Medicaid and commercial contracts added across multiple states for a telepsychiatry provider serving hospitals
Services for hospitals and health systems
Take one service or run them together. Hospitals that want the whole job done usually choose complete payor management.
Payor contracting
Inpatient, outpatient and professional agreements negotiated from market data
Credentialing
Employed clinicians, facilities and new locations enrolled and kept enrolled
Complete payor management
Contracting, credentialing and revenue cycle, including denials and complex claims, by one team on one fee
Revenue cycle management
Professional and facility billing support, 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
Hospital contracting questions
Do you work with hospitals or only physician practices?
Both. Hospital work includes community and independent hospitals, critical access and rural hospitals, post-acute hospitals such as long-term acute care and rehabilitation facilities, and small health systems, along with their employed physician groups.
Can you negotiate inpatient and outpatient contracts?
Yes. Inpatient DRG and per diem terms, outpatient fee schedules and professional fee schedules for employed clinicians are negotiated together, so one agreement does not improve at the expense of another.
How do you handle site-neutral payment problems?
Claim by claim, with the payor, in standing joint operating committee meetings where needed, and by writing the terms into the renegotiated contract so the problem does not recur.
We already have a managed care lead. How do you fit?
As an extension of that person or team. PayrHealth takes the modeling, payor correspondence, credentialing and follow-up, and your lead keeps the relationships and the decisions. Some hospital clients start this way, during a vacancy or an acquisition.
Can you credential our employed physicians and new locations?
Yes. Hospitalists, employed specialists, advanced practice providers and new locations or departments are enrolled with commercial payors, Medicare and Medicaid, and kept enrolled.
How long does a hospital renegotiation take?
New rates typically take effect 8 to 12 months after kickoff, depending on the payor and the contract's renewal terms. Credentialing and enrollment move faster, and the annual calendar starts the next renegotiation early enough to avoid a lapse.
Do you provide market benchmarks?
Yes. Each agreement is modeled against market data for comparable hospitals in your market, by service line and code, and the same data supports the proposal to the payor.
How do you report to our board?
Through the client portal and scheduled reviews, with reimbursement by payor and service line against market benchmarks, negotiation status and credentialing status in one place.
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 hospital, your service lines and your top payors. If you qualify, we show you where your contracts sit against comparable hospitals 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.
