Payor Contracting Solutions That Drive Optimal Reimbursement and Results

Your Contracts. Your Leverage. Our Expertise.

At Legacy Consulting Services, we believe your payor contracts should reflect the true value of the care you provide. Whether you're negotiating new agreements or optimizing existing ones, our experts ensure you're not leaving money on the table.

We don't just accept the standard - we demand better!

Let's evaluate your payor contracts and uncover new revenue opportunities.

At Legacy Consulting Services, we specialize in helping healthcare providers and practices secure and negotiate favorable contracts with insurance payors to ensure optimal reimbursement and financial stability.

Our experienced team works directly with payors to negotiate terms that maximize your revenue and minimize administrative burdens. We are committed to securing the best contracts for your unique needs.

Our Services

We offer a full suite of payor contracting and contract negotiation services, including:

  • New Payor Contracts

    Expanding your network with new payors can increase your patient base and revenue. Our team assists in identifying the right payors for your practice and negotiates new contracts that are favorable and aligned with your financial goals.

  • Payor Contract Negotiation

    We analyze your current contracts and negotiate with insurance companies to improve reimbursement rates, terms, and payment timelines.

  • Contract Review & Compliance

    We thoroughly review existing contracts to ensure they comply with all regulations and are optimized for your practice's specific needs.

  • Fee Schedule Analysis

    Our experts assess payor fee schedules to identify areas for improvement and advise on negotiation strategies.

  • Revenue Cycle Integration

    We integrate contracting strategies with your revenue cycle to ensure maximum reimbursement from day one.

  • Ongoing Support

    We provide continuous support, helping you navigate any future contract changes or disputes that arise.

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Why Payor Contracting Matters

Payor contracting is vital to the financial health and long-term sustainability of healthcare providers. It involves negotiating terms with insurers (e.g., Medicare, Medicaid, private payors) to ensure fair reimbursement for services. Here's why it matters:

  • Boosts Financial Stability

    Strong contracts mean better reimbursement rates-helping you avoid underpayment and maximize revenue.

  • Expands Your Patient Base

    Being in-network with more payors increases patient access and attracts those seeking covered providers.

  • Ensures Predictable Cash Flow

    Favorable terms support timely, accurate payments-making financial planning easier.

  • Strengthens Negotiation Power

    More contracts = more leverage. This helps you secure better rates and reduce admin burdens.

  • Supports Cost Control

    Clear, fair contracts reduce billing surprises and help you budget more effectively.

  • Reduces Admin Hassles

    Well-defined terms streamline claims and reduce denials, appeals, and delays.

  • Enables Strategic Growth

    New payor agreements can open doors to new services, markets, and patient demographics.

  • Promotes Long-Term Sustainability

    Sound contracts protect your practice's financial future and support high-quality patient care.

That's why we take on the hard work of:

  • Managing initial provider credentialing and contracting services
  • Conducting reimbursement or fee schedule analysis to compare against current reimbursements
  • Identifying opportunities to renegotiate commercial insurance contracts
  • Drafting persuasive payor negotiation letters that highlight patient satisfaction, outcomes, and demographic value
  • Setting defined negotiation targets-optimum, minimum, and realistic goals

Our Comprehensive Contracting Management Process

Our healthcare consulting services are tailored to support your financial goals and optimize medical billing revenue through strategic contract management. Legacy's approach includes:

  • Evaluation of your payer reimbursement analysis against national and regional benchmarks

  • Identification of underperforming in-network provider contracting agreements

  • Proposal of modifications for evergreen contract management

  • Ongoing contract lifecycle support, including annual reviews and renegotiations

  • Advocacy during provider-payor negotiations to secure the best possible rates

Did You Know?

70% of physician groups are underpaid compared to regional market benchmarks - simply because their contracts haven't been renegotiated in over 5 years. Don't let that be you.

Frequently Asked Questions

What is payor contracting?

Payor contracting is the process of establishing agreements between healthcare providers and insurance payors to define service reimbursements, coverage, and network status. These contracts outline the terms, rates, and other conditions of payment for the services you provide.

Client Success Snapshot: Payor Contracting Wins

Client: Multi-specialty physician group in Alabama
Challenge: Below-market reimbursement rates and contract delays with a major commercial payors

Solution:

  • Conducted full contract analysis and fee schedule comparison

  • Identified negotiation leverage using market data and provider performance metrics

  • Re-negotiated terms including increased rates and reduced prior authorization requirements

Results:

  • 18% increase in reimbursement across key CPT codes

  • Contract executed 6 weeks faster than previous renewal cycle

  • Improved payor relationship and faster credentialing for new providers

What to Expect

Step 1: Contract Discovery & Analysis
Step 2: Market Rate Comparison & Opportunity Mapping
Step 3: Strategic Negotiation & Payor Engagement
Step 4: Contract Finalization & Implementation
Step 5: Ongoing Monitoring & Renegotiation Support

What Our Customers Have to Say

Featured Article

Contracting

Payor Contracting – It’s a Marathon, not a Sprint

By Donna White | February 16, 2017

One of the most common areas the Legacy team sees providers losing money is in their payor contracts. You open your practice, sign your initial contract with the payor for a set fee schedule, then you start seeing patients. Most payors will try to get you to sign an initial two or three-year contract. Each […]

Let's Secure the Contracts You Deserve

Partner with Legacy and gain a team that fights for your financial future, understands the fine print, and delivers real, measurable outcomes.

Our team is ready to uncover hidden revenue and strengthen your negotiating position.