Alexi Health
Book a call
All services Alexi Health — Payer Contract Negotiation

Reimbursement That Reflects the Care You Actually Deliver.

Being in-network isn't the same as being paid fairly. Alexi Health reviews, benchmarks, and negotiates your payer contracts so your rates keep pace with your value — not a fee schedule set years ago.

Book a free consultation Contact us
Credentialed Isn't the Same as Fairly Paid

Every Payer Contract Deserves a Second Look

Most practices sign a payer contract once and never revisit it — even as costs rise, care models evolve, and competitors negotiate better terms. Alexi Health treats contract negotiation as an ongoing discipline, not a one-time signature.

  • Rate Analysis & Benchmarking

    Comparing your current reimbursement rates against Medicare, regional, and specialty benchmarks to identify exactly where you're underpaid.

  • Contract Review & Redlining

    Line-by-line review of payer contracts to flag unfavorable terms, timely filing traps, and clauses that quietly limit your leverage.

  • Multi-Payer Negotiation Strategy

    Coordinated negotiation across all your payer relationships, so gains with one contract inform leverage with the next.

  • Renewal & Escalation Planning

    Tracking renewal windows and building in rate escalators before you're locked into another multi-year term at old rates.

  • Value-Based Contract Terms

    Structuring quality bonuses, shared savings, and risk-adjusted terms as payers shift away from pure fee-for-service.

  • Network Adequacy Protection

    Ensuring termination and network participation clauses protect your patient base and revenue if a payer relationship changes.

How a Negotiation Actually Runs

A Structured Process, Not a Single Phone Call

  1. Contract Audit

    We review every active payer contract and identify where rates and terms fall short.

  2. Benchmarking

    We compare your rates to market and Medicare data to build a data-backed case.

  3. Negotiation

    We lead or support negotiations directly with payer representatives on your behalf.

  4. Monitoring

    We track the new terms and flag the next renewal before it becomes a deadline.

Full Scope of Support

Every Angle of the Contract, Covered

  • Fee schedule analysis Comparing reimbursement across CPT codes to find where your specialty is underpaid.

  • Contract language review Identifying unfavorable clauses on timely filing, bundling, and downcoding.

  • Negotiation representation Direct engagement with payer contracting teams so you don't negotiate alone.

  • Multi-location contract alignment Consistent terms across every site as your practice grows.

  • Value-based term structuring Building quality incentives and shared-savings terms into new contracts.

  • Renewal calendar management Advance notice before auto-renewal locks in outdated terms.

  • Termination clause review Protecting your patient panel if a payer relationship needs to end.

  • Ongoing rate monitoring Continuous tracking to flag when it's time to renegotiate again.

Why Practices Rarely Do This Alone

Payers Negotiate for a Living. You Shouldn't Have To.

  1. Leverage Is Asymmetric

    Payers have dedicated contracting teams and data; most practices negotiate a handful of times in their history.

  2. Contracts Are Deliberately Complex

    Bundling rules, downcoding clauses, and timely filing limits are often buried in language built to favor the payer.

  3. Rates Rarely Move on Their Own

    Without a renegotiation request, most contracts simply auto-renew at the same or worse terms year after year.

  4. The Market Is Shifting Fast

    Value-based and risk-sharing terms are becoming standard — practices without expert guidance risk signing bad new models.

A contract you signed years ago shouldn't still be setting today's reimbursement rates.

Alexi Health

Find Out What You're Leaving on the Table

Let Alexi Health audit your current payer contracts and show you exactly where better terms are available.

Schedule a Free Consultation
Keep exploring

Other services