Expert insights on healthcare transparency, compliance requirements, and industry best practices. Stay informed with actionable guidance for healthcare organizations.
A multi-specialty coding and billing guide for physician groups. Covers CPT, modifier 25, NPP rules, and fee schedules in multi-specialty practices.
The Transparency in Coverage rule was marketed as a consumer shopping tool, but the files it produced let provider contracting teams see what payers pay their competitors. This guide explains what's actually in the data, why the raw files mislead you, and how to use them to benchmark your rates and strengthen your next negotiation.
Independent clinical laboratories CPT coding & billing: Current Procedural Terminology codes, payer reimbursement, administrative service codes, medical services.
2026 ophthalmology and retina coding guide for the retina practice. CPT codes, billing and coding, diagnostic imaging, cataract, ophthalmic reimbursement.
The 2026 oncology coding guide for community practice owners. ICD-10 sequencing, chemo CPT hierarchy, drug J-codes, and where revenue actually leaks.
Behavioral health coding guide built for physician groups: 2026 BHI and CoCM codes, why correct claims still deny, real reimbursement rates, and CoCM break-even math.
PayerPrice gives you instant access to negotiated rate data across payers and providers so you can benchmark, negotiate, and optimize with confidence.
Navigate value-based care contracts with our guide for physician groups. Learn about risk-sharing agreements, payer incentives, and real-world quality metrics.
Every PPO vs HMO vs Exchange comparison online is written for consumers choosing a plan. This one is written for physician groups managing a payer mix. Here's how each plan type affects your reimbursement rates, administrative costs, and bottom line.
Most physician groups negotiate payer contracts without knowing how their rates compare to the market. This guide walks through how to benchmark your commercial reimbursement rates, what data sources are available in 2026, and how to turn that analysis into a stronger negotiation position.
The contract you signed looks fair on paper. But buried in the fine print are clauses that let payers rewrite your rates, claw back payments from years ago, and downcode your claims without reviewing a single chart. Here are the five red flags that cost providers the most money, and how to spot them.
Physician groups lose 5-7% of net revenue to payer underpayments hidden in zero-balance claims. Learn how to detect patterns and recover what you're owed.
Learn how physician groups can use Transparency in Coverage negotiated rate data to benchmark rates, build payer-ready analyses, and win contract increases.
37% of physician groups never negotiate payer contracts. Learn the benchmarking methods, contract clauses, and tactics that close the reimbursement rate gap.
Complete guide to managed care contracting for healthcare providers. Understand contract types, essential components, payment models, and common challenges in 2026.
Understand physician group payer mix. Learn about payer types like Medicare, Medicaid, self-pay, & commercial health insurance. Optimize revenue cycle.
Physician groups lose revenue to payer contracts silently, through underpayments and neglected renegotiations. Here's the payer contract management system to fix it.
When organizations get strategic about payer contract management, they see real improvements including 4-8% increase in net collection rates and 15-30% reduction in claim denial rates.
Payer strategy and contracting: Negotiate competitive reimbursement rates. Employ strong payer strategies for better payment & financial performance.
Organizations that tap into claims data often see faster payment cycles, fewer losses, and smarter use of resources.
AI solutions could save $150 million to $300 million in administrative costs for every $10 billion in payer revenue.
It's about time drug prices become public.
How ApolloMD compressed payer negotiations from months to days using payer‑published, penny‑accurate rates.
