Managed Care Contracting

Negotiate stronger payer contracts, manage fee schedules, and ensure you're paid correctly under every agreement.

Better Contracts, Better Revenue

Payer contracts directly determine your reimbursement rates — yet many providers sign unfavorable agreements without fully understanding their financial impact. Hetasalvation's managed care specialists analyze your existing contracts, identify underperformance, and negotiate improved rates and terms.

From initial contract modeling through ongoing performance monitoring and renegotiation, we ensure every payer relationship is working as hard as possible for your organization.

Discuss Contract Management →
Managed Care Contracting

Managed Care Solutions

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Contract Negotiation

Data-driven payer contract negotiations that leverage your volume, quality outcomes, and market position to achieve above-market reimbursement rates.

  • Market rate benchmarking
  • Negotiation strategy development
  • Term sheet review & redlining
  • Counter-proposal preparation
  • Negotiation representation
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Contract Modeling & Analysis

Financial modeling of proposed contract terms against your actual utilization data — so you know exactly what a rate change is worth before you sign.

  • Rate impact modeling
  • Procedure-level financial analysis
  • Service line profitability analysis
  • Break-even analysis by payer
  • Scenario modeling for negotiations
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Fee Schedule Management

Load, maintain, and audit payer fee schedules in your billing system — ensuring you're billed correctly and paid according to your contracted rates.

  • Fee schedule loading & maintenance
  • Rate change implementation
  • Fee schedule variance analysis
  • Underpayment identification
  • Payer rate reconciliation
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Contract Performance Monitoring

Ongoing monitoring of actual payments against contracted rates — identifying systematic underpayments and holding payers accountable to contract terms.

  • Contractual adjustment accuracy review
  • Systematic underpayment detection
  • Payer performance scorecards
  • Contract compliance reporting
  • Recoupment demand management
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Value-Based Contract Support

Advisory support for shared savings, bundled payment, capitation, and other value-based arrangements — aligning your operations to succeed under risk.

  • VBC contract interpretation
  • Quality metric tracking
  • Risk stratification support
  • Care management program alignment
  • Shared savings calculation review
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Contract Repository Management

Centralized contract repository with expiration tracking, amendment logging, and renewal alerts — ensuring no contract lapses without strategic review.

  • Contract database setup
  • Expiration & renewal tracking
  • Amendment management
  • Contract term library
  • Credentialing coordination

Are Your Payer Contracts Working for You?

Our managed care experts will benchmark your rates and identify negotiation opportunities.