Know what you should be paid, then ask for it
We compare your payer contracts and actual payments with Medicare and market benchmarks, find underpayments, and prepare the rate request. You keep the payer relationship and the final decision.
Contract Review
We read each contract for rate schedules, timely filing and appeal windows, payment deadlines, escalators and termination terms.
Rate Benchmarking
We compare your rates for your highest-volume codes with Medicare and with what other payers pay you, and flag the outliers.
Underpayment Analysis
We compare what each payer paid with what the contract says it should pay, and list the claims that were short-paid.
Negotiation Preparation
We build the ask: the rate request, the supporting data and the case for it, written so you can send it or present it.
Negotiation Support
We prepare talking points, draft letters and review counteroffers with you. Rate outcomes depend on your market and your payer, and we do not promise a specific increase.
Renewal Calendar
We track notice dates and renewal windows so a contract never auto-renews at an old rate because a date was missed.
Collect contracts and fee schedules
You send current contracts, fee schedules and a recent remittance sample.
Benchmark and analyze
We compare rates, find underpayments and note the terms that cost you money.
Findings meeting
We walk you through the results and agree which payers to approach first.
Prepare and support negotiation
We prepare the request and support you through the back and forth.
Track results and renewals
We record the outcome and set reminders for the next renewal window.
- Practices whose contracts have not been reviewed in several years
- Groups with several payers paying well below the benchmark
- New or growing practices about to sign their first contracts
- Practices that suspect systematic underpayments
Related reading and services: Payer contract negotiation guide · Credentialing & Enrollment · Denial Management · Out-of-Network & NSA Dispute Support.
Most practices sign a contract once and never look again
Payer contracts quietly decide your revenue. A rate that was fair at signing can sit unchanged through years of rising costs, and auto-renewal clauses mean a missed notice date locks it in for another term. The terms matter too: timely filing limits, appeal windows and payment deadlines all change what you actually collect.
Benchmarks make the case. Comparing your rates on your highest-volume codes against Medicare, and against what other payers pay you for the same services, shows where you're low. If one commercial payer pays 20 points less than another for the same code, that's a conversation worth having.
Underpayments are the other half. Payers sometimes pay below the contracted rate, and unless someone compares each payment with the fee schedule, it's posted as paid in full. Those short-pays have appeal windows too.
How a contract review runs
- Week 1: Collect the filesYou send current contracts, fee schedules and a recent sample of remittances.
- Weeks 2 to 3: Benchmark and analyzeWe compare rates, find underpayments and note the terms that cost you money.
- Week 4: Findings meetingWe walk you through the results and agree which payers to approach first.
- Weeks 5 to 8: Prepare and supportWe write the rate request, the supporting data and the case for it, then support you through the back and forth.
- Ongoing: Track outcomes and renewalsWe record the outcome and set reminders for notice and renewal dates.
Who to approach first
Start with your highest-revenue payers and your highest-volume codes. A 3% rate improvement on a payer that represents 40% of your revenue beats a 10% improvement on one that represents 2%. We rank payers by the dollars at stake before anything goes to the table.
What contracting support costs
Payer contracting support is a standalone service for most practices and is included in our Enterprise billing tier. We quote it after a short intake based on the number of payers and contracts in scope.
We don't promise a specific rate increase, because outcomes depend on your market, your volume and the payer. You keep the relationship and make the final decision.
Questions we hear most
Will you negotiate directly with payers?
We prepare the request, the data and the talking points, and support you through the process. You keep the payer relationship and the final decision.
What do you compare my rates against?
Medicare fee schedules and what your other payers pay you for the same codes, focused on your highest-volume services.
How do you find underpayments?
By comparing each payment with the contracted fee schedule on a remittance sample, then listing every short-paid claim.
When should I review a contract?
Before the renewal notice window opens. We keep a calendar so you're never renewing at an old rate because a date was missed.
Related: Payer contract negotiation guide · Aged A/R recovery · Denial management · Pricing.
Want a second opinion on your payer contracts?
Send us one contract and a recent remittance. We will tell you what looks off and whether a full review is worth it.
Start With a Free Assessment →