Analysis fee

What the analysis fee covers

Every engagement starts with an analysis of 4 commercial payer contracts. It's a fixed fee based on your practice's size, and it's credited toward negotiating your first contract.

1. Step 1

   Contract review

   Full read of four commercial payer agreements: term, renewal, notice and amendment language.

   What you get

   • Effective date, term and renewal type for each agreement
   • Notice deadlines and the next window to renegotiate
   • Amendment and fee-schedule change rights

2. Step 2

   CPT rate check

   Every contracted code compared to market medians and ceilings for the specialty and state.

   What you get

   • Paid rate vs. Medicare, market median and market ceiling per code
   • Rate as a percentage of Medicare
   • Annual dollar gap using your volumes

3. Step 3

   Clause risk review

   Evergreen renewals, one-sided amendments, all-products, recoupment and timely-filing terms flagged.

   What you get

   • Each risky clause quoted word for word
   • Severity rating (high, medium, low)
   • What to ask for in the renegotiation

4. Step 4

   Payer mix analysis

   Revenue and volume by carrier to rank which contracts to renegotiate first.

   What you get

   • Share of revenue by carrier
   • Priority order for renegotiation
   • Where volume gives you the most leverage

5. Step 5

   Written opportunity report

   Dollarized upside by payer and code, with the negotiation targets.

   What you get

   • Conservative, expected and best-case annual upside
   • Top codes to target with the dollar value of each
   • Engagement fees and the performance fee estimate

6. Step 6

   Strategy call

   Walk-through of the report with the practice's leadership and the plan for each carrier.

   What you get

   • Review of findings with your leadership team
   • Agreed plan and timeline for each carrier
   • Clear next steps, with no obligation to continue