Payor Portfolio Management

Payor Portfolio
Management

Boost your revenue and get paid more quickly
with better payor contracts.

What is Payor Portfolio Management?

Independent healthcare providers lack the funds and manpower that large organizations devote to constantly monitoring their payor contracts, allowing these giants to jostle payors for the most profitable contracts and reimbursement terms. In contrast, independent providers (IPs) often simply take contracts as they come, as they don’t have access to the resources and know-how to successfully negotiate for better rates.

Payor portfolio management (PPM) seeks to boost IPs’ revenue by identifying, negotiating or re-negotiating, and securing new or existing contracts with key payors in the provider’s market. In addition to the initial review and procurement of payor contracts, PayrHealth’s PPM services extend to year-round proactive maintenance, ensuring that when opportunities arise that could further benefit the provider, we’re ready to negotiate and pursue better terms and rates.

Independent providers often leave contracts untouched for years, going through renewal after renewal without checking to see if the market has changed for certain codes that could help them earn more money. In many cases, it has, which is why payor portfolio review and proactive contract monitoring are so important; these contracts are costing your practice money every day.

The timeline for new market expansion varies, as certain applications are only available once every few years. That’s why identifying every necessary provider and specialty contract opportunity before jumping into the negotiation and credentialing phase is vital; it ensures you don’t waste time applying for a region you won’t get this year anyway.

Understanding Payor Contracts

Most IP administrators and physicians have enough knowledge to understand the majority of payor contracts, but payors often slip language into the fine print that limits the reimbursement the practice is eligible for. This includes limiting the number of days a practice has to submit a claim, which services are covered, and how quickly the payor must return reimbursement for an accepted claim.

These factors affect when and how your practice is paid, as well as how much and for which procedures. That’s why it’s so important to have a partner involved who can negotiate these contracts to secure better terms so you can be paid more and quicker for your services.  

Payor portfolio management (PPM) seeks to boost IPs’ revenue by identifying, negotiating or re-negotiating, and securing new or existing contracts with key payors in the provider’s market. In addition to the initial review and procurement of payor contracts, PayrHealth’s PPM services extend to year-round proactive maintenance, ensuring that when opportunities arise that could further benefit the provider, we’re ready to negotiate and pursue better terms and rates.

How PayrHealth Makes A Difference

PayrHealth becomes your partner for every step of the contracting process, from identifying priority payors to proactively managing your whole portfolio. By optimizing your major contracts, you can see double-digit percentage increases in under a year. Not only that, but you also take advantage of our robust database of real-time information on market benchmarks for key procedures, ensuring that any change that’s coming won’t pass your practice by.

The entire contracting process is handled by our highly experienced team, meaning you don’t have to spend a minute on the phone with a payor — we handle it all for you so you can focus on what you do best.

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Payor Portfolio Management Services

Case Study

$500K Revenue Increase In A Single Year

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.”

About PayrHealth

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.

U.S. Based

Meet with a team that understands your unique needs wherever you are.

Deep Experience

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.

Growth Focused

We’re a growing company, too! We focus on your growth and aim to be a dependable partner for years to come. 

Our Process

Independent providers can be as involved or hands-off as they want with PPM, and PayrHealth provides frequent reporting and updates throughout each contract negotiation cycle. Here’s what you can expect after onboarding and meeting your dedicated Client Success team lead.

01

Strategize

The process starts with an in-depth analysis of your current contract portfolio, identifying key contracts to re-negotiate and areas of potential growth and new patient acquisition with new contracts. We’ll formulate a value proposition that gives a clear outline of the results of our analysis and goals for your contract portfolio.

02

Negotiate

Once we have agreed on a value proposition that’s acceptable to you, we begin the work of contacting payors, requesting new contracts, escalating when receiving denials, and counter-proposing. We will keep you updated throughout this process and have you review and sign new contract terms when they are accepted by the payor.

03

Report

With PPM, you get bi-weekly meetings with our team to discuss progress and to keep ourselves aligned with your goals and our strategy’s deliverables. Each quarter, we’ll also have a comprehensive report on the results and progress of our strategy, which evolves as the landscape of your payor marketplace evolves.

04

Grow

When you have competitive rates and reasonable terms, your payor contracts drive revenue growth with better and faster reimbursement for your services. This helps independent providers scale, tapping into new markets, procedures, and patients for long-term success and sustainable growth.

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Contact PayrHealth

If you want to learn more about how PPM can help your specific practice grow and thrive, take the first step by contacting PayrHealth today. We’ve negotiated over 50,000 contracts in all 50 states, so we know what unique needs different independent providers come to the table with. Contact us online or give us a call today to find out how PayrHealth can help optimize your contract portfolio with payor portfolio management.

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