Payer Contract Analysis

Payer Contract Analysis

In order to get a strong idea of what your contracts look like, TriumpHealth’s experienced consultants perform a comprehensive contract review. This allows them to better understand exactly what your contract terms are and gives them the opportunity to analyze the language that is used by the payers. This process requires a heightened level of understanding of the following factors that give you leverage as a provider for negotiations:

• Fee Schedule
• Reduction Rates
• Relative Value Units (RVUs)
• Timely Filing Rules
• Patient Volumes
• Claim Filing Limits
• Appeals Qualifications
• Market Value Based on Taxonomy

Once our team has a clear understanding of what your payer contract contains, we identify strengths, weaknesses, and improvement opportunities and review them with you. We take the time to explain any threats of unsatisfactory payer contracts so that you are aware of what needs to be negotiated. Not all payer contracts need to be negotiated, so our consultants identify where you would benefit from negotiation. Let our team of trained professionals take the time to ensure that your contract contains optimal terms while you focus on providing optimal care for your patients.