Payor Contracting

Effective Strategies & Education

“SMSC was a tremendous help with our payor contracting and negotiation process. They performed a comprehensive contract review of our primary commercial payor contracts and provided a detailed analysis that identified both immediate and longer-term opportunities for revenue enhancement. They shared specific points to use in negotiations that I was able to use successfully in contract renewal discussions with payors.”

Jim Hueber, Colorado Imaging Associates

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SMSC provides a suite of services that helps organizations create effective payor strategies, develop more favorable reimbursement rates and contract terms, and enhance their ability to maximize traditional and non-traditional payment arrangements. Examples of our success include:

  • Experienced Staff


    Demonstrated expertise in negotiating higher-than-standard rates with commercial payors to yield additional revenue.

  • Flexible Service


    Contracting using a variety of reimbursement methodologies from fee-for-service to bundles to case rates.

  • Extensive Network


    Developing relationships with outside providers or other organizations to effectively partner in alternative payment models and risk-based arrangements.

  • On-Going Support


    Creating effective, ongoing education for providers and business staff.

  • Customized Programs


    Building unique programs with TPAs and self-funded employer groups to increase direct referral sources.

Key Services

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Evaluate contract language to identify problematic policies and terms for contracts in place.

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Identify opportunities for financial increases through claims analysis and reporting.

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Create strategies for promoting specific service lines or procedures with carriers or purchasers.

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Conduct a market review and identify opportunities to capitalize on unique offerings.

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Develop outreach approaches for fostering stronger relationships with carriers and provider networks.

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Develop a payor contracting strategy to align with desired objectives.

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Create a plan for maximizing reimbursement opportunities, including alternate payment methodologies such as carve-outs/case rates, risk-based, or purchaser-direct.

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Assess readiness for bundled payments, including potential opportunities for partnering with other local providers.

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Provide insight into potential operational impacts of risk-based or bundled arrangements.

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Deliver ongoing coaching & education to providers and other staff regarding the benefits, implications, and risk mitigation for non-FFS payment model.

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Provide coaching on approaches for payor negotiation success.

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Key Service Line Team Members

David Landry

Chief Executive Officer & Board Member

Amy Johnson

Director, Payor Contracting

Improve Your Payor Strategies