Contract intelligence
Payer scorecards
Reimbursement lift, denial drivers, days-in-AR, and authorization friction — graded by payer so renegotiations have receipts.
Active payer contracts
22
Avg reimbursement
$184 / RVU
Days in AR
38
Denial rate
6.2%
Top payers — performance
- BlueCross BlueShield GA · Reimb +4% · Denials 3.1% · AR 32dok
- Aetna Commercial · Reimb flat · Denials 5.8% · AR 41dinfo
- United Healthcare · Reimb −2% · Denials 9.4% · AR 52dwarn
- Medicare Advantage (Humana) · Reimb +1% · Denials 4.2% · AR 36dok
- Georgia Medicaid · Reimb stable · Denials 7.1% · AR 47dinfo
Denial drivers (top 5)
- Missing prior auth — 31%
- Coding mismatch (CPT/ICD) — 22%
- Eligibility lapse — 14%
- Medical necessity — 12%
- Timely filing — 8%
Negotiation leverage
- UHC: quality scores in top quartile — push +6% schedule
- Aetna: VBC pilot ready — share savings 50/50
- BCBS: extend through 2027 in exchange for telehealth parity
- Medicaid: advocate state-led PA reform