Complete Payor Management
What is Complete Payor Management?
Independent providers (IPs) often lack the budget and time that large networks dedicate to ensuring they’re getting the best reimbursement rates, the most approved claims, and the best payor contracts. The big players in healthcare have entire departments for contract negotiation and claim resubmission that IPs simply can’t compete with. This means they’re likely facing revenue leakage from issues like outdated codes leading to claim denial, contracts with less-than-ideal rates and benefits, and valuable time spent in-office handling payor contracting and billing.
That’s where PayrHealth comes in. With Complete Payor Management, we become a partner to independent practices, providing complete support to help them manage payor relationships and increase reimbursements. Complete Payor Management is comprised of payor portfolio management and revenue cycle management.
Our Complete Payor Management Includes:
Payor Portfolio Management
With payor portfolio management (PPM), we perform a data-driven review of IPs’ current contracts, identifying areas of potential improvement based on current marketplace trends in their region. From there, our team of experts create a contracting strategy to proactively negotiate or renegotiate payor contracts to help them get the best rates possible—the type of contracts large healthcare facilities are able to negotiate with their in-house teams of payor portfolio managers.
We handle all aspects of portfolio maintenance and constantly monitor trends and changes in the industry to help practices stay not just with the curve but ahead of it. Our proactive data collection allows us to watch the markets in all 50 states and help providers everywhere get a higher claim approval rate and competitive contracts to decrease revenue leakage.
Revenue Cycle Management
Complete Payor management includes revenue cycle management (RCM), again driven by our robust and proactive database, to help IPs manage billing and claim submission, accounts receivable, credentialing, and out-of-network profiling. This gives practices extra time to focus on patient care while our team handles the tedious tasks while making sure you get the reimbursement you deserve from competitive payor contracts. When claims are denied, we automatically resubmit them, something an in-office team member may be tasked with but never finds the time to do.
Payor Portfolio Management Services
Revenue Cycle Management Services
Benefits of Complete Payor Management
Simply put, Complete Payor management with PayrHealth helps increase revenue by decreasing leakage and negotiating for the most competitive payor contracts.
Specifically, Complete Payor management helps by:
· Obtaining and renegotiating contracts on behalf of the practice to achieve competitive rates
· Proactively identifying problems and solving them quickly to prevent lost revenue
· Partnering with practices to provide them the same resources and data that the biggest players have access to
· Outsourcing accounts receivable and billing to a team of industry experts to free up time for in-office staff members
· Providing reports on reimbursement rates and claim acceptance rates to drive decision-making and contracting strategy.
We know the leaders of independent providers are being asked to be CFOs as well as MDs, which is why PayrHealth takes on the role to help them focus on taking care of patient
Who is Eligible for Complete Payor Management?
PayrHealth is uniquely suited to provide help for small to medium independent healthcare providers across the United States. We partner with a diverse group across healthcare industries, from urology to durable medical equipment (DME) providers.
New practices also benefit from Complete Payor management, securing the best contracts from the start without ever having to worry about billing, claim submission, or credentialing. Whether you see 50 or 5000 patients, we can be your partner for payor contracting and revenue cycle management.
Bone & Joint Surgery Center of Novi wanted to renegotiate their top three revenue-producing payer contracts, and PayrHealth’s experience brought an increased reimbursement, realizing a double-digit percentage increase to their major contracts.
Our experience with PayrHealth was spectacular! Not only are they affordable for ASC’s, they fully understand insurance contract negotiations while offering a software that allows you to analyze your current contracts.”
PayrHealth is an all-in-one payor relationship management solution. We strategically and proactively manage contracts, payor relationships, and revenue cycles to help level the playing field between independent providers and payors.
Meet with a team that understands your unique needs wherever you are.
Our team covers and have solved problems in a wide-ranging variety of provider industries.
Small & Medium Size Providers
We look out for those who need our services and expertise the most.
We’re a growing company, too! We focus on your growth and aim to be a dependable partner for years to come.
When you partner with PayrHealth, you get dedicated industry experts who will create a payor contracting strategy, secure and negotiate contracts on your behalf, and report on our progress through our portal and in regular reporting check-ins. Complete payor management is an ongoing relationship rather than a one-off project, which means we will continue to get to know your unique practice, industry, and market to help both you and us make the best decisions for your practice’s goals.
Onboarding will grant us the opportunity to meet your dedicated team and complete our preparation package
Strategy consists of jointly identifying customer goals to develop prioritized payer contract targets
Payor Coordination sets us up as an extension of your team to navigate the labyrinth of payer representatives
Process Reporting strengthens your payer portfolio to yield more patients and higher reimbursements
Growth and real-time status updates and bi-weekly meetings track progress and updates our strategy
How To Begin
If you’re interested in Complete Payor management to help drive revenue growth and free up your practice to focus on patient care, the first step is to contact us by giving us a call or contacting us online today. Complete payor management is about creating a relationship that helps independent providers stay independent while leveraging the latest data to increase revenue and secure better contracts. Start the conversation with us today to find out how we can be your long-term partner for sustained, robust growth.