Complete payor management: contracting, credentialing and revenue cycle, run as one function
Contracting, credentialing and revenue cycle usually sit in separate departments that rarely talk to each other. One PayrHealth team negotiates your contracts, enrolls your providers, bills and works the denials and complex claims, and checks each payment against the contract, for one fee tied to your collections.
Founded in 1994 as Healthcents, PayrHealth since 2021. Contracting, credentialing and revenue cycle under one roof, run as one team.
What complete payor management covers
The three functions that decide whether you get paid, integrated so a contract, an enrollment and a claim are handled by people who talk to each other.
Each piece is also available on its own: payor contracting, credentialing and revenue cycle management. Complete payor management is for organizations that want them run together, by one team, on one fee.
Not sure where to start? See if you qualify for a free rate review and we will show you where your contracts sit against your market.
How complete payor management works
Your first year with PayrHealth, from onboarding to a plan that renews every year, with contracts, enrollments and claims on one calendar and progress in one portal.
Onboarding
Month 1Contracts, fee schedules, rosters, open receivables and payor contacts collected through paperless intake, your dedicated team meets yours, and billing moves to PayrHealth in weeks 2 to 4, without a gap in cash flow.
Strategy
Months 1–2Every contract modeled against market data, targets ranked by revenue and negotiating position, enrollment gaps and claim backlogs inventoried, and the year's calendar set for all three functions.
Negotiation, enrollment and transition
Months 2–8Priority contracts renegotiated and new ones pursued, and providers and locations enrolled before each contract takes effect.
Growth
Month 8 onwardNew rates loaded, verified and billed at the contracted amount, next-tier contracts opened, and new services and locations added to the plan.
Reporting and follow-up
ThroughoutDenials, complex claims and payor issues worked as they arise, with contracts, applications and claims in one 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.
Complete payor management results
payor contracts secured and 3M+ new covered lives for a Texas pain and orthopedic group, a PayrHealth client since 2018
in added annual revenue from renegotiated payor contracts, including a 45% increase on its top payor contract
priority payor contracts others had called unobtainable, opening 4.3M+ covered lives
Who we work with
Complete payor management for organizations that want one accountable partner for payors, from a single-specialty practice to a multi-state platform.
Hospitals and health systems
A managed care department for community and independent hospitals, without the headcount
Surgery centers
Ambulatory surgery centers, from the first contract to the renegotiation, with facility billing on the same plan
Physician groups
Single and multi-specialty groups, from one location to many, with contracts and credentialing on one plan
Ancillary providers
DME suppliers, labs, imaging, home health and hospice, and post-acute facilities
Private equity-backed platforms: portfolio-wide contracting, changes of ownership and enrollment across acquisitions.
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
Complete payor management questions
What is complete payor management?
PayrHealth's bundled service: payor contracting, provider and facility credentialing, and revenue cycle management, including denials and complex claims, run by one team on one plan. It is the integrated version of the three services we also offer separately.
Why run the three functions together?
Because they fail at the seams. A contract that is negotiated but never loaded, a provider who is hired but not enrolled, a claim paid below the contracted rate that nobody catches: each one sits between departments. One team that owns all three closes the gaps.
Is this only for large organizations?
No. Complete payor management fits independent practices, hospitals, surgery centers and ancillary providers, from a single location to multi-state platforms, in all 50 states.
Does it include billing and collections?
Yes. Revenue cycle management is part of the bundle: charge capture and coding review, claim submission, denial management, payor and patient follow-up and reporting, inside your existing practice management system.
What do you mean by complex claims?
The claims a standard billing workflow leaves behind: site-neutral payment disputes, underpayments against the contract, prior authorization and medical necessity denials, bundling and multiple-procedure edits, and claims tied to a change of ownership. We work them to resolution with the payor, and feed the cause back into the contract or the front end.
How is complete payor management priced?
As one bundled fee set as a percentage of collections, so PayrHealth is paid as you are paid and has the same long-term interest in your rates, your enrollments and your collections. The proposal states the exact terms.
How do you decide which contracts to negotiate first?
By revenue at stake and negotiating position. Each contract is modeled against the best-paid quarter of practices like yours, for the same codes, in your market, then ranked by each payor's share of your commercial lives and the size of the gap.
How long until we see results?
Enrollment fixes and claim corrections show up within the first months. Renegotiated rates typically take effect 8 to 12 months after kickoff, once contracts are signed and providers are enrolled, and the plan renews every year after that.
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 and your top payors. If you qualify, we show you where your contracts sit against the best-paid quarter of practices 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.
