Provider Consulting

"CHC’s contracting efforts and market understanding brought new, immediate, revenue to our organization.”
-- Brian Fowler, MD – Urgent Care & Occupational Health Centers of Texas
Managing Your “Managed Care Portfolio”

A significant amount of costs, in terms of time and resources, are associated with the effective management of existing and new contractual relationships with third party payers. CHC relieves office staff of the need to managed these contractual relationships and focus on their primary responsibilities. In many cases, this includes: patient care, patient relations, filing of claims, and accounts receivable. CHC’s services ensure best practices are followed, without the need to reinvent existing day-to-day operational workflows, and bring additional revenue opportunities to the organization.


  • Determine IPA / PHO affiliations

  • Manage direct employer relationships

  • Identify individual versus group contractual relationships

  • Provide regular demographic updates

  • Confirm existing participation status

  • Secure hard copies of executed agreements and other relevant documents

  • Extract / manage key provisions within executed agreements
            (“Contract Cheat Sheet”)

  • Provide payer contact information

  • Determine multiple product participation status

  • Identify membership penetration and large employer group network usage

  • Obtain payment methodologies and reimbursement allowable information

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    Systematic Approach to Maximizing a Provider’s Profitability

    Strong, market acceptable, third party payer contracts are integral to the success of any provider practice as they are the primary revenue stream into the organization. Many providers, or provider groups, enter into contractual relationships without fully understanding the nature of their existing patient mix and the complexity behind the third party payer contracts in which they enter. A systematic approach is required to make informed contractual decisions in order to maximize the overall profitability of the organization. CHC has built a reputation to effectively manage these daily administrative tasks while providing long term solutions to the practice.


  • Practice “snap shot”

  • Analyze patient and payer mix

  • Evaluate coding / billing practices

  • Network payment compliance reporting

  • Existing / strong carrier relationships

  • Contract–to–Contract reimbursement comparisons

  • Develop fee schedule or charge master structures

  • Regular feedback regarding external industry activities

  • Perform credentialing and/or re-credentialing functions

  • Contract verbiage review supported by alternative language options

  • Extensive contracting experience due to prior network development responsibilities

  • Provide third party payer contracting strategies specific to practice utilization patterns and market dynamics

  • Financial analysis and reimbursement modeling to support pre-approved network negotiation and/or
            renegotiation efforts

  • Marketing services to provide increased patient volume, larger referral base, direct employer relationships, and
            patient steerage into “preferred” third party agreements

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