Payer Strategy & Contracting
Ventra clients who re-negotiated payer contracts in 2024 achieved a 7% increase in revenue on average.
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Expert Advocacy and Negotiation
Reimbursement begins with the contract. Our Payer Strategy & Contracting team ensures yours are fair, in line with market benchmarks, and optimized to pay you appropriately for the services you deliver.
Data-Driven Approach
We leverage our vast database of rates and terms to build data-driven support for reimbursement strategy and contract negotiations.
Comprehensive Strategy
We take a full-spectrum view of your payer landscape, reviewing current contracts, payer performance, regional benchmarks, and regulatory changes.
Experienced Negotiators
Our team understands the markets and payer behavior, and we draw on our longstanding payer relationships to reach agreement on your behalf.
No Surprises Act
We use the NSA process to bring out-of-network providers to the table with reasonable rates. We win 80% of those cases.
Advocacy
We’ll fight for you when policy changes or payer behavior impact revenue and reimbursement.
Payer Performance
We stay engaged beyond the negotiation to track contract performance and aggressively work with payers to resolve any payment issues.
Policy Updates
We stay on top of regulatory and payer policy changes, engaging our Client Success and Service Delivery teams to proactively address issues that may impact revenue.
“A strong payer contract is our first line of defense against changing market conditions.”
— Shanna Howe , Vice President, Strategic Partnerships
The Ventra Health Advantage
Training, Expertise, and Technology That Put You in Charge
Ventra invests in the technology, education, and training that give you insights into your practice’s financial health. We partner with you to turn those insights into strategy.
Resources
- Critical 2025 CPT Updates for Anesthesia/Pain ManagementEach year, the AMA updates the existing CPT codes used for submitting claims. These changes can include deletions of existing … Read more
- CPT 2025 Update: MRI Safety Measure Codes A new set of codes and guidelines for reporting MR safety services are effective January 1, 2025. These new codes … Read more
- Overcoming RCM Challenges in Interventional RadiologyInterventional radiology (IR) is a unique subspecialty within Radiology. Because of the nuances and differentiation from diagnostic radiology, IR can … Read more
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