Payer contract negotiation
Turn rate data into a quantified payer proposal.
Compare rates, model a target using your business mix, and prepare a workbook and draft payer letter.
Market comparisons and planning estimates for your next rate request.
Find your largest modeled revenue gains.
A small rate gap on a common code can matter more than a large gap on a rarely billed service.
Add your payer mix, service mix, and revenue to estimate the impact of closing market rate gaps.
BUILD YOUR RATE REQUEST
Model the financial impact of the rates you plan to request.
Choose a payer and enter your current rates.
Choose your payer and services. Enter current rates or check the model's available rate sources.
Set a rate target using comparable providers.
Select providers in your market and setting. Inspect their rates before choosing a target percentile.
Test your target against payer mix, service mix, and revenue.
Adjust your target, payer mix, service mix, and revenue. Check the estimate and any missing rates.
PREPARE YOUR PAYER MATERIALS
Export your model and draft a payer negotiation letter.
Export your workbook and draft letter. Check proposed rates and complete contract details before sending.
The letter starts at the 75th percentile. Add your payer history and decide the final ask.
Schedule a negotiation walkthroughTrace your revenue estimate to its rates and assumptions.
Check rate sources, market comparisons, and business inputs before making your request.
Read the modeling FAQs →Check your current-rate basis
Check whether rates came from your inputs, payer publications, or linked practice records.
Inspect the rates behind your target
Inspect the providers and rates behind your target to check that the selected market and services fit your practice.
Check the revenue and business mix used in your estimate
Check revenue, payer mix, service mix, and missing rates to see how much of your business is modeled.
Check how targets, estimates, and draft letters are calculated.
Check what the target means, how the estimate works, and what still needs your team's input.
Schedule a negotiation walkthrough →Where do the current rates come from?
Use rates you enter, published billing-entity rates, or available fee-schedule data from linked practice records.
Check the source and confirm which rate represents your contract.
How do we choose which payer and codes to address first?
Start with your next payer conversation and the services that matter to your practice.
Use payer and service mix to compare the potential impact of different targets.
What if transparency data does not show our exact current rate?
Enter a current rate from your fee schedule.
Rows without usable current or comparison rates are excluded.
Check missing rates before interpreting the total.
What does the target percentile mean?
Choose a 50th-, 75th-, or 90th-percentile market target.
The percentile describes a rate's position in your comparison. It does not predict what your payer will accept.
What does the modeled annual difference mean?
Positive current-to-target rate differences are weighted by payer mix and service mix.
Those weighted differences are applied to your supplied revenue.
It is a planning estimate, not a claim-by-claim forecast or guaranteed increase.
Can we inspect the evidence behind the target?
Supported model cells open detailed rates for the comparison.
Review the rates and model inputs, then export the workbook for further analysis.
Does the draft letter use my selected model target?
The letter starts with a 75th-percentile request, even if you modeled a different target.
It includes up to 20 payer-code rows, ranked by modeled opportunity.
Review the increase and complete contract and relationship details before sending.
Does PayerPrice negotiate with the payer for us?
PayerPrice provides the analysis, workbook, and draft letter.
Your team or contracting adviser chooses the final request and conducts the negotiation.
Walk through a rate proposal with our team.
Bring one payer, your current rates, and key services. Model your next rate request with our team.