Testimonials
A Florida Vascular OBL
18% Contract Renegotiations Increase
Addressing Unfair Rates
A Florida vascular group with an OBL had been facing low reimbursement for years. They were never been able to negotiate reimbursement rates on their own.
The Issue
Payers in Florida are notoriously difficult to work, often never giving increases in reimbursement and often unilaterally decreasing rates. This group had suffered this exact scenario for years with UHC, BCBS, Humana, and most of their other major payer contracts.
The Solution
NGA Healthcare gathered all the payer contracts, fee schedules, and modeled a years worth of CPT data to benchmark the practice's rates. In many cases the group was being underpaid compared to their contract rates, which NGA Healthcare also helped to resolve. NGA crafted a value proposition using proprietary data, unique practice selling points, and regional rate comparisons. The value proposition was used to reinforce the practices leverage, along with negotiation skill sets and decades of experience from NGA Healthcare's team over the months long negotiation.
The Outcome
After 8 months NGA Healthcare had successfully negotiated several the groups commercial contracts an average of 18% higher, resulting in hundreds of thousands of additional annual revenue.
A Kentucky Vascular Office/OBL
200% of CMS Avg. | New Contract Negotiations
Maximizing a new group's reimbursement potential
NGA Healthcare was retained to obtain new contracts, negotiate carveouts for specific high value procedures, and credential a newly built OBL in Kentucky.
The Issue
A talented surgeon was leaving another group to open a vascular clinic/OBL in an underserved area in Kentucky. NGA Healthcare knew that his new OBL would save the payers millions compared having the procedures performed by the local hospital systems. The physician needed expert guidance to credential his practice and maximize the reimbursement from his payer contracts.
The Solution
NGA Healthcare relayed the value of this new group and OBL to the payers and fought for carveouts on his OBL procedures. NGA also pushed the payers to credential the group in a timely fashion and presented the payers with a value proposition that demonstrated the cost savings the group represented to their networks.
The Outcome
After 7 months, the client had all their major contracts and effective dates in hand. Even more importantly NGA helped them obtain rates that rivaled the local health systems with an average reimbursement 200% of Medicare for the commercial lines of business!
Video Testimonials
Customer Quotes
“I started this process not really understanding how contract negotiations work at all. NGA was actually instrumental in getting my contracts in place before I opened doors. They were extremely helpful in pushing back on low-ball rates.”
Dr. Amy Pate, Rocky Mountain Wound Care
“The collaborative effort between the two entities was outstanding, and because of such we were able to obtain significant gains both on our urology contracts and even more than what I thought we were going to get for our ASC contracts. Their expertise was second to none.”
Rick Gerdts, CFO, Urology Nevada and Surgery Nevada
“NGA is an integral part of our practice and key in managing our payor contracts. Navigating the medical landscape as a private practice without NGA would be like being lost in the Alaskan wilderness without a guide. NGA has been an immense help with our upstart and also in maintaining and updating contracts as we go forward.”
Dr. Keith Thompson, CEO, Vein Institute of South Mississippi
“We've appreciated our relationship with NGA Healthcare. Over the last year and a half, we felt like they've really been a real advocate for our business when it comes to insurance companies… They've made it a lot easier to deal with some of the inflation issues that we've seen.”
Dr. Curtis Nielsen, Advanced Orthopedics in Lehigh, Utah
“I've used them ever since… probably at least 5 years ago that I did the initial credentialing for my insurance for the OBL. I'm very grateful to Nathaniel and Garrett for helping me with the details of what needs to be done for CAQH, as well as any other insurance companies that want to be part of our team. They're very important to me and I like them, and they're very cordial, very respectful, and it's a real great help to my practice.”
Dr. Patricia Thorpe, Pulse Cardiovascular Institute in Phoenix, Arizona