Payer Contracting and Management Services for Healthcare Providers
The Diamond Group helps healthcare providers develop and execute business strategies for growth and projectable income. We create payer contracting solutions that expand your market and access to clients through a targeted payer strategy.
This frees you to focus on your core business: Healthcare delivery.
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Specialists in Behavioral Contracting
We create payer contracting solutions that expand your market and access to clients through a targeted payer strategy.
Your Partner in Growth
Outsource Your Provider Strategy Team
From single facility start-ups to multi-state providers and all models in between, The Diamond Group can help guide your strategy, state by state, payer by payer.
If you have considered payer contracting to grow your business, you might be asking, “Where do I start? Who do I call?” You may have already started the process and encountered obstacles. Perhaps your application was denied because it was incomplete or doesn’t meet the payer requirements, or you are simply told the network is closed to new applicants.
Payer contracting can be frustrating and time-consuming. The Diamond Group can help.
Since 2010, The Diamond Group has been helping providers like you access and navigate the myriad obstacles. Not all payer contracts are the same and there is no one-size-fits-all solution. We understand the system. Our relationships with the payers and our subject matter expertise enable us to:
- Cut through bureaucracy
- Present your value proposition most effectively
- Negotiate the most favorable contract terms and maximize revenue
- Expedite implementation
Our Consulting Services
Payer contracting is complicated. When you are ready to move forward, The Diamond Group will meet with your executive team to explain the pros and cons of payer contracting, discuss competitive positioning, and determine the right strategy for your business. From this we create a specific Scope of Work and identify those payers best suited for your market and business objectives.
The Diamond Group will create a marketing packet to present to the payers that differentiates you from your competitors. We will:
- Secure commitments from health plans to accept applications
- Complete applications and submit to payers for processing
- Manage the due diligence during the credentialing process
- Negotiate contract terms and conditions
Acting on your behalf, we negotiate the best possible terms with insurance companies. We have extensive experience working with a wide range of payers, so you can be confident we will find the best solution and obtain the most favorable rates for you.
Once your contract has been issued, there are compliance and reporting requirements to manage and maintain. The Diamond Group ensures you remain in compliance by managing your account. We can take care of ongoing payer relationship management, handle contract administration, renewals, and rate increases.
As specialists in behavioral health contracting, The Diamond Group works with many types of providers, large and small — local, regional, and national. Let our market data and experience guide you. If you are expanding into new markets, we can help identify payer market needs and gaps in network coverage. Examples of our services include:
- Market research
- Identifying barriers to entry
- Competitor analysis
- Rate analysis
Our Process
Our clients are diverse and provide a range of specialty health care services:
- Chemical Dependency/Substance Use Disorders
- Eating Disorders
- Mental Health
- Mental Health Specialty Practices
- Psychological & Psychiatric Forensic Practices
- Durable Medical Equipment Suppliers
- Home Health
- Hospice Care
Ascend Healthcare, LLC
Windward Way
ComfortCare Pharmacy and Home Medical Products
Alsana
We Work with All Major Insurers
