Payor Management & Negotiations

Zetter HealthCare proudly offers services for payor management and negotiations. A payor contract defines a healthcare practice’s reimbursement arrangement for providing healthcare services to patients covered by a health plan. Luckily, the professionals at Zetter HealthCare are experts in understanding the terms of payer contracts. We can assist you in managing reimbursements to ensure the correct amount is reimbursed each time. Additionally, we assist your practice in renegotiating these contracts to ensure your practice is maximizing its revenue.
 

Payor Management & Negotiations Contract Review

First, we conduct thorough research in order to determine what leverage you have with payers. Next, we perform a complete analysis of all the reimbursement data that your company has from the last two years. Then, with this data, we can determine how the reimbursement is done by plan and payor.

To begin your payor negotiations, we determine what other leverage sets your practice apart from competitors. Then, we conduct a thorough review of your contracts. In addition, during our payor management and negotiations, our professionals communicate what terms in the contract should be renegotiated. This step provides more favorable contract terms for our clients.
 

Additional Reimbursement

On top of re-negotiating contract terms, we also determine a strategy for requesting additional reimbursement. This may include:

• Increased reimbursement
• Carve-outs for specific services
• Terms in the language that may allow the practice to have longer appeal rights
• Quicker turnaround time on reimbursements

When you choose Zetter HealthCare, you are choosing success. Providing a strategy for additional reimbursement brings us greater success rather than creating a proposal for negotiating contracts. We are committed to helping our clients maximize their profits. Given our years of experience and expertise, we’re able to set our clients up for success.

For assistance with payer management and negotiations, contact us online or call Zetter HealthCare at (717) 691-6768.