Services / Contracting
Payer contracting & contract negotiation services
New payer contracts, fee schedule benchmarking and rate renegotiation that secure better reimbursement for your practice — before the first claim is billed against them.
How we do it
Every claim your practice bills is paid against a contract, and most practices have not read theirs since they were signed. Fee schedules that were negotiated years ago, evergreen renewals that quietly roll over, and plan products added without a rate review all cap your revenue before billing even starts. Our contracting service puts those agreements back under your control.
We start by benchmarking your current fee schedules against Medicare and against what comparable Florida practices are paid for the same codes, so you know where each payer stands. From there we handle new payer applications, negotiate rates and terms on your behalf, and work the renewal cycle so renegotiations happen on your schedule rather than the plan’s. In Florida that includes the Medicare Advantage and managed Medicaid plans that now carry a large share of most practices’ volume.
Contracting and billing belong together. Once a contract is in place we load the agreed rates into our follow-up process, so every remittance is checked against what the payer actually agreed to pay — and underpayments are appealed with the contract language to back them up.
What’s included
Everything contracting should cover.
- New payer contracts and re-negotiations
- Fee schedule review and benchmarking
- Rate negotiation on your behalf
- Ongoing contract lifecycle management
Common questions
Contracting questions, answered.
- Can you negotiate with payers on behalf of a small practice?
- Yes. Leverage comes from preparation more than size: documented quality metrics, your patient volume in the plan’s network, specialty access in your market and a clear benchmark of where the proposed rates fall. We prepare that case and run the negotiation, and we are honest when a plan is unlikely to move so your time goes where it will pay.
- Which Florida payers do you contract with?
- We work with the commercial carriers that dominate Florida — Florida Blue, UnitedHealthcare, Aetna, Cigna and Humana — along with Medicare Advantage plans, Florida’s Statewide Medicaid Managed Care plans, workers’ compensation and auto PIP carriers. If a plan is active in your market, we can pursue a contract with it.
- How long does payer contracting take?
- New contracts typically run 60 to 120 days from application to effective date, driven by the payer’s credentialing and committee calendar. Renegotiations depend on your current contract’s notice and renewal terms, which is why we review those dates first and work the cycle ahead of the deadline.