Contract Negotiation & Payer Relations

We advocate directly with commercial payers to secure favorable, enforceable agreements for substance use disorder and behavioral health providers.

Our experience working with complex payer environments, including those in California and Florida, allows us to approach negotiations with market awareness, reimbursement intelligence, and operational insight.

Strategic Contract Negotiation

Behavioral health reimbursement varies significantly by payer and level of care. We negotiate commercial payer contracts with a focus on sustainable rates, clear authorization standards, and enforceable payment terms.

Our goal is not just network participation, but financially viable participation.

Rate Analysis & Benchmarking

Before entering or renegotiating a contract, we conduct structured rate analysis to evaluate:

• Reimbursement by level of care
• Comparison to regional benchmarks
• Parity compliance considerations
• Impact on staffing and operational costs

This ensures that contract decisions align with real operational expenses.

Contract Compliance Review

We review existing agreements to confirm that payers are reimbursing in accordance with contracted terms. When discrepancies are identified, we initiate structured resolution processes to recover underpayments.

Ongoing Payer Relationship Management

Strong payer relationships reduce friction and speed resolution. We manage ongoing communication, address systemic issues, and escalate disputes when necessary.

Our team functions as an intermediary between your leadership team and payer representatives, ensuring concerns are addressed efficiently and professionally.

Strengthening Your Payer Position

Effective contract strategy directly impacts cash flow, authorization approval rates, and long term growth. We help providers build payer relationships that support stability rather than uncertainty.