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Contract Negotiations

Three Essential Phrases That Protect You in Payer Contract Negotiations

November 28, 2025 / admin / Articles, Contract Analysis, Contract Management, Contract Negotiations, Contracting, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contract Negotiations, Payer Contracting, Payer Contracts
Payer Contracting Experts Talking in a Healthcare Group HQ

Reimbursements represent a significant source of revenue for healthcare organizations. Yet many providers don’t receive the full payment they’ve earned for services they deliver, even when both sides have agreed on rates. The culprit? Hidden policy changes, unexpected claim denials, and gaps in contract language that leave providers vulnerable to revenue loss. Most healthcare organizations […]

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Contract Analysis, Contract Management, Contract Negotiations, Contracting, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contract Negotiations, Payer Contracting, Payer Contracts

Mastering Payer Contracts in Home Health

November 10, 2025 / admin / Articles, Contract Negotiations, Contracting, Home Health, Home Health Contracting, Home Health Services, Payer Contract, Payer Contract Negotiation, Payer Contracting, Payer Contracts, Payer Negotiations
Home Health Worker, White Female Treating a Male Patient

Payer contracts form the backbone of any home health agency’s financial infrastructure. These agreements determine how you’ll be reimbursed, which services are covered, and ultimately whether your agency can maintain a healthy bottom line while delivering quality care. For agencies working to build reliable revenue streams and operational efficiency, getting these contracts is essential. Let’s […]

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Contract Negotiations, Contracting, Data-Driven Negotiations, Home Health, Home Health Care, Home Health Contracting, Home Health Services, Home Healthcare, Payer Contract, Payer Contract Negotiation, Payer Contracting, Payer Contracts, Payer Negotiations, Strategic Payer Negotiations

Provider Challenges in Payer Contracting

November 4, 2025 / admin / Articles, Contract Analysis, Contract Management, Contract Negotiations, Contracting, Contracting AI, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contracting, Payer Contracts
A Group of Contracted Doctors Standing in Times Square

Healthcare providers face constant battles when negotiating and managing contracts with insurance companies. These obstacles affect every type of practice, from solo physicians to massive hospital networks. The difficulties come from unequal bargaining power, hidden information, endless paperwork, and the overwhelming number of different insurance companies in the market. For most providers, dealing with payer […]

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Contract Analysis, Contract Management, Contract Negotiations, Contracting, Contracting AI, Payer Contract, Payer Contract Analysis, Payer Contract Management, Payer Contracting, Payer Contracts

Tax Status Dictates Contract Structure

October 14, 2025 / admin / Articles, Billing and Contracting, Contract Negotiations, Contracting, Corporation, Partnership, Payer Contract, Payer Contracting, Payer Contracts, Sole Proprietor, Tax Status, Tax Status Shapes Credentialing, Value-Based Care, Value-Based Models
Tax Status Dictates Contract Structure (Doctor Signing)

When healthcare providers set up their practices, one of the first decisions they make is choosing their business entity type. While this might seem like a routine administrative task, that choice carries far more weight than most realize. Your tax status fundamentally shapes every contract you’ll negotiate with insurance companies, how you bill for services, […]

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Billing and Contracting, Contract Negotiations, Contracting, Corporation, Partnership, Payer Contract, Payer Contracting, Payer Contracts, Sole Proprietor, Tax Status, Tax Status Shapes Credentialing, Value Based Care, Value-Based Models

Strategic Payer Negotiations: A Data-Driven Approach

September 11, 2025 / admin / Articles, Contract Negotiations, Data-Driven, Data-Driven Negotiations, Data-Driven Payer Negotiations, Payer Negotiations, Scott Ellsworth, Strategic Payer Negotiations, Value-Based Care, Value-Based Care Models

Healthcare providers today face mounting pressures from multiple directions. Administrative burdens continue to pile up, denial rates are climbing, and reimbursement rates lag behind inflation. Yet many hospitals and health systems approach payer negotiations with the same old playbook, leaving significant money on the table and accepting contract terms that don’t serve their organization’s best […]

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Contract Negotiations, Data-Driven, Data-Driven Negotiations, Data-Driven Payer Negotiations, Payer Negotiations, Scott Ellsworth, Strategic Payer Negotiations, Value Based Care, Value-Based Care Models

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

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