Payer Contracting: Strategy & Planning

For many providers, payer contracting can be a daunting proposition. From experienced multi-state facility operators to single practice and facility startups, many of the questions and concerns remain the same. The Diamond Group is here to help. We will make payer contracting easy for you.

The first step is to meet with your team to learn about your business profile and your objectives.

We will describe the payer environment and current climate, and the best opportunities and timeframes for accomplishing your goals.

Healthcare providers are facing challenging times. We can help you develop a strategic plan for business expansion, including acquisitions. We will identify barriers to entry and guide you through the change of ownership requirements.

From the strategy and planning session we create a Scope of Work document for the design and implementation of your payer contracting strategy. This includes:

Identifying the best payers for your practice

Reviewing the contract options available and potential rates

Reviewing your existing contracts and rates

Leading the contract negotiation

Preparing the documentation necessary for a streamlined credentialing process

The Diamond Group understands payer contracting from the perspectives of both the payers and providers.

This helps us ensure that you always get the best possible contract and rates.

We know the process and the people involved, as well as pitfalls to avoid. By engaging us to develop your payer contracting strategy, you take an important step in expanding your market, increasing revenues, and stabilizing income.

We work with a broad spectrum of payers:

Commercial: All Major Healthcare Plans

Medicare: Medicare Advantage Plans

Small Regional Carriers

Government Payers

It has been incredible to work with Lisa and her team. Our industry is hard enough and to know respected people are in my corner helps make my job that much easier. The Diamond Group gets the job done and we appreciate all their hard work.

Effie Goldberg, Managing Director
Ascend Healthcare, LLC

I have worked with Lisa Diamond for almost five years. Lisa and her team have helped us navigate the ever-changing landscape of insurance payers and every facet of the contracting process. The Diamond Group helped secure network contracts with every major payer in the country and negotiated the most competitive rates. And they provided invaluable support when we sold our business, ensuring there was no disruption in our cash flows. I highly recommend Lisa and The Diamond Group for any matter regarding partnering with an insurance company. They are the best!

Jesse Kellert, CEO
Windward Way

The Diamond Group consultants, headed by Lisa Diamond, are very professional and productive, and it has been a pleasure working with them for over eight years. They are leaders in healthcare marketing and contracting with diverse payer sources. Our durable medical equipment, pharmacy, and audiology establishment has grown and flourished while surviving the changes in the healthcare industry because of The Diamond Group’s careful planning and presentation of our products and services in a very professional and clever manner to different types of healthcare payers and referral sources.

Heidi Kavoukjian, President
ComfortCare Pharmacy and Home Medical Products

Alsana has partnered with Lisa Diamond since I joined as CFO in 2018. For the first two years, Lisa and her team served as our payer contracting department maintaining and improving existing contracts, executing amendments for new locations, and managing the integration of payer contracts for an acquisition we did. She continues to support us with special projects and back office administration. I appreciate and respect Lisa’s knowledge of the healthcare industry, her creative solutions and her commitment to helping us achieve our goals.

Blaine Faulkner, Chief Financial Officer
Alsana

Contact us for a free, no-strings, initial consultation.

We will give you an honest assessment of your payer contracting options, and whether it makes sense to engage us. And we will explain our fee structure so that you have all you need to make a decision.

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