Costs and contract terms change constantly.
Are your payor agreements keeping pace?
For more than 26 years, Joel S. Duhl, Inc. has helped hospitals, IPAs, ACOs and physician practices evaluate payor agreements and negotiate terms that fit their community and business needs.
It’s hard enough to balance expenses with reimbursements. Don’t let an outdated contract create even more pressure on your bottom line. We have the experience and the track record to help you negotiate your payor agreements and manage all of your payor contracts.
Contract Evaluation
& Negotiation Services
We help you make data-driven decisions regarding your payor agreements.
Evaluate. We will analyze the contract and financial terms for each payor agreement that you provide. This will help you understand the pros and cons of each contract, and highlight any areas of concern.
Recommend. We will review the findings with you and recommend a course of action.
Execute. We will negotiate the contract and financial terms with the payors, keeping you informed of our progress. We will receive your input and decisions until the agreements are complete.
Maintain. We are available throughout the year to assist in addressing any contract issues at your request.
Prompt. We will advise you when it is time to renegotiate payor agreements.
Why Should You Invest in Our Services?
Consider the impact to your bottom line if you’re losing money every day because of an outdated payor agreement. Our analysis will pinpoint the changes in reimbursement and terms that require updating.
Payor agreements are typically evergreen. They renew automatically unless they are renegotiated. The insurance company is not going to approach you unless it is in their best interest. You need to be proactive and initiate the negotiation process.
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Contracts are tricky business. They’re dense and hard to understand. And the medical landscape continues to shift in response to Medicare changes and new requirements. It’s easy to miss or misunderstand clauses that can have far-reaching impact on your bottom line. We can help you avoid costly mistakes.
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Inflation alone has increased costs almost 19% from 2018-2022. Imagine the losses you are sustaining if you are being reimbursed according to an old agreement!
Who Benefits From This Service?
Each situation is different. Your negotiating position depends in part on your market and the demand for your services.
That being said, the following organizations typically can realize significant benefit as a result of professional contract negotiation services:
Hospitals, especially those in less competitive markets where there are fewer service providers.
Physician organizations (ACO or IPA).
Larger physician practices.
Smaller specialty practices that have a commanding or exclusive market share.
Joel S. Duhl
Mr. Joel S. Duhl is the principal of Joel S. Duhl, Inc. He has served medical practitioners and other businesses in the healthcare industry for over forty years.
Mr. Duhl holds a Bachelor of Science degree in Finance and a Master of Business Administration from Northern Illinois University in DeKalb, IL.
His wide-ranging experience includes both administration and finance in nursing homes, hospitals, outpatient rehabilitation centers, physician practices and physician associations.
His experience includes:
32 years of consulting expertise on a variety of operational and finance topics, including payor contract negotiation, practice efficiency, budgeting and cash flow, revenue improvement, and emerging medical issues such as patient-centered medical home and meaningful use.
More than 20 years of experience managing physician organizations ranging in size from fifty to two hundred members.
Has managed ACOs and clinically integrated networks.
Founder of Resolve Health Plan Administrators, a third-party administration and management company.