Most Practices aren't getting the rates that they deserve. NGA Healthcare has a success rate of 100% in negotiating contracts; we have been able to negotiate at least one major contract for each of our clients.
We set up a call to discuss the status of a Clients contracts, and to understand the pain points for each practice. NGA submits a proposal to the client, outlining the process, fees, and the plans NGA will pursue increase from.
Once a client procures our services, we send them a list of data points and information that we'll need to analyze their rates and create a value proposition.
We benchmark your practices’ allowable rates by individual CPT against Medicare to understand your bottom line on a granular level.
An in depth value proposition is created that highlights all of the practice’s unique capabilities and savings for to the health plans.
We submit the value proposition to each plan and initiate the negotiation process. Over the course of weeks and months we make the irrefutable case for an increase to the plans. We don’t take “No" for an answer.
NGA is committed to getting our clients higher rates, even after months of stalling and delays, NGA sticks with the negotiations. We don’t stop until we get the increase your practice is entitled to.
This medium-sized practice has been open for 6 years and has a roster comprised of 5 medical doctors and 3 mid-level providers. Annual Revenue is $4,650,000* broken down according to the following payment mix:
Medicare - 25%
Medicaid - 10%
Commercial Payer 1 - 20%
Commercial Payer 2 - 10%
Commercial Payer 3 - 10%
Commercial Payer 4 - 20%
Commercial Payer 5 - 5%
After a comprehensive meeting to scrutinize and discuss our strategy, leverage, and competitive advantages, we analyzed the practice’s CPT codes according to the payers above and weighted the number of encounters.
We found what each of the payers was reimbursing, as compared to Medicare…
Using our long-standing health plan contacts, we started the several month-long negotiation process. Even after initially refusing any increases, the Payer ultimately agreed to an 18% increase over current rates from 78.25% to 96.25%. The result?
An extra $168,483 PER YEAR, year after year!
All of that revenue was essentially profit for the practice. No additional expenses were required to increase their bottom line.
All with just ONE payer. Imagine what that could mean for your practice.
Timelines for negotiation services are highly dependent on the payers. Most negotiations take on average between 6 and 8 months between the signing of the contract and the signing of the addendum with increased rates. NGA Healthcare works tirelessly to obtain your practice the increase it deserves, and our entire payment structure was designed to align our incentives with your practice. The sooner we get you a large rate increase, the sooner we all benefit.
Ambulatory Surgery Centers (ASCS)
Allergy & Immunology
Addiction and Drug Treatment Centers
Anesthesiology (Pain Centers)
Behavioral Health (Psychiatry/Psychology)
Ear, Nose, and Throat
Imaging Centers Labs
Obstetrics & Gynecology
OBLs (Office Based Labs)
Ophthalmology & Optometry
Surgery (General, Eye, Endovascular, Hand, Orthopedic, Retinal, Spinal, Vascular, etc)
States we work in ...
All 50 States!