Become in-network with Medicare, Medicaid,
and Commercial payors and optimize reimbursements
In today’s healthcare payment landscape, every dollar counts. Increasing regulations, downward fee pressure from the government, and decreasing reimbursements have been on the rise and hitting practices hard. Plus, today’s contracting environment is tougher than ever.
With the potential for declining reimbursements, practices that fail to monitor contracts are likely leaving thousands of dollars on the table. Negotiating contracts and fee schedules annually is essential to optimizing reimbursement and, ultimately, yields a significant return on investment to your organization.
Now more than ever, it’s crucial that you get the most out of your payor contracts and to do that, it’s imperative to negotiate. However, successful negotiation takes significant effort and can stretch a practice’s resources.
Legacy can take all that off your hands. We manage the initial payor contracting, future contract review, reimbursement analysis, and renegotiation on your behalf. And we can efficiently keep up with it, year after year, to maximize your reimbursements and return on investment.
We analyze your current reimbursement against fee schedules and start contract review and negotiations. Our process includes
- Comparing the overall weighted averages of your healthcare plans.
- Proposing modifications to health plan contracts (most are evergreen and otherwise automatically renew).
- Drafting a payor letter that explains the benefits your patients achieve from the care you provide and includes patient satisfaction data, the demographic area you serve, and more.
- Preparing for contract negotiation and setting a range that includes an optimum, minimum, and target goal.
Don’t feel forced to accept truly poor contract terms, because you fear rejecting contracts might disrupt ongoing care for some patients, decrease in the number of new patients, interfere in established referral patterns, and result in loss of income. We take those burdens on for you, and payors want to work with us to keep you in-network for their patients.
When you have payor contracts and more favorable terms, you’ll be in a better position to compete and thrive – even in “this age of declining reimbursements.”
What Our Customers Have to Say
As the founder of IOP Services LLC I have worked with the Legacy staff in detail. IOP Services is an outpatient behavioral health facility and its launch required licensure through a CON board, Joint Commission accreditation, then Credentialing , rate negotiation, and contracting with key insurance companies. Legacy was responsible for the payor portion of the project. Simply put, they made a very daunting project look easy. Communication was always immediate and clear. The results exceeded expectations.
Founder of IOP Services LLC
We searched extensively for the right credentialing and billing partner for our telepsychiatry startup, ultimately deciding that Legacy was the most knowledgeable and cost efficient option for us and that decision has been rewarded on an almost daily basis. Donna and her team are experts in the credentialing and contracting space, able to not only get our providers in network with major insurance payers as well as FHCPs but have become our go-to source of guidance as we negotiate with the payers and plan the optimal way to structure our organization to make it as accessible to those who are paying with insurance as possible.
They are professional, results oriented, swift and personable. I would recommend the Legacy team to anyone who is looking to initiate or optimize their insurance credentialing, contracting or billing operation!
Intern, Cerebral Medical Group
Based on the recommendation of a colleague, we reached out to Legacy Consulting to help us with the credentialing for our new surgeon. Donna, Jennifer and the rest of their team exceeded our expectations in getting all the major payors provider numbers prior to our new doctor starting. We will definitely use them again and would highly recommend them for all of your credentialing needs.
Administrator, Surgical Clinic PC
We have used Legacy Consulting for several credentialing projects. They have been extremely knowledgeable, thorough and timely in their responses. They have taken a challenging process and made it streamlined and easy for me as an administrator. We highly recommend them!
Administrator, Lee Obstetrics and Gynecology
I have had the privilege and the opportunity to work with and to learn from Donna Carter-White. Our working relationship began in 2001 when the company in which I was a founding partner acquired Rehab Associates. During the due diligence phase of the acquisition the entire team was impressed with the organization and proficiency with which Donna ran the billing operation. She was much more than a billing executive and was involved in every aspect of the Rehab Associates business. Her expertise extended into the operations and the clinical aspects of the business. The growth in the business and the contractual and referral relationships were due in a large measure to Donna’s business development efforts. She assisted in the tremendous growth in the marketplace of Rehab Associates and continued in this role being the contact with all of the major payers and clients. The performance of the billing operation and Donna’s oversight of that area made Rehab Associates a valuable addition to the Benchmark enterprise.
When the acquisition was finalized, the focus was on integrating as much of the business in the Montgomery office under Donna’s leadership. This enabled the company to consolidate many of the existing billing operations into the Montgomery Central Billing Office. Donna has proven herself to be an outstanding executive. Her organization skills as well as her written and oral communication skills are outstanding. She is as at home in a board room as she is working side by side with her billing staff. She makes it a practice to understand and to bring insight and innovation into each area for which she is responsible. She always presents herself in a professional and confident manner and she has an innate ability to establish trust among both her subordinates, senior management and her clients. Her leadership skills are outstanding and she has the loyal support of her staff. She thinks outside the box and is constantly improving and refining the processes. Her cash to revenue goals are always met and exceeded and she monitors and controls costs keeping her cost per visit for billing well below the national average.
Peg Lentz O’Donnell
Principal, O’Donnell Consulting
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 […]