Nurse Practitioner Contracting Services 

Payer contracting for nurse practitioners is an essential component of the launch and growth of your NP practice. Contracting with insurance companies opens your clinic to more patients in your area. 

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Payer Contacting for NPs 

After credentialing with healthcare payers, NP entrepreneurs must begin securing contacts with commercial payers and Federal programs. According to the U.S. Census, more than 90 percent of people in the U.S. have health insurance coverage. Because of this, it is critical that you understand the top payers in your area.

Our team will submit applications, review fee schedules, and analyze reimbursement rates, simplifying contracting with insurance companies for nurse practitioners. With proper healthcare data and reports in hand, our team will also manage the process of negotiating payer contracts.

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Benefits of NP Payer Contracting Services 

Reimbursement for nurse practitioners’ private practices can heavily rely on successfully securing profitable contracts. Partnering with NP Advantage consultants connects the processes of credentialing, payer contracting, and billing and coding, increasing revenue opportunities. 

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Increased Patient Volume

Qualify yourself as a care solution for more patients in your area by contracting with key payers in your geography. 

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Contract Review Experience

Our team has a wealth of experience reviewing fee-for-service and value-based care contracts from Medicare and commercial payers. 

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Secure Higher Payments

We work with NP practice owners to ensure fair compensation for services rendered and will lead contract negotiations when appropriate. 

Nurse Practitioner Payer Contracting Services 

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Payer Mix Analysis

We thoroughly analyze claims data and market intelligence to pinpoint the most compatible payer networks for your independent practice. 

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Payer Contracts Management

NP Advantage consultants assist with credentialing requirements, contract documents, and reimbursement arrangements across your various health plans. 

Day to day support

Fee-For-Service Contracts

Often, new practices must start with fee-for-service contracts. To support your NP business, our consultants secure optimal contacts and consult on documentation best practices. 

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NP Enrollment Verification

Our team works to confirm that the identified payers are open to contracting with independent NPs, advocating on your behalf. 

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Documenting Care for Reimbursement

Our EHR documentation and billing and coding consultants will work with practice staff to ensure documentation meets contracting requirements. 

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Value-Based Care Contracts

Healthcare is shifting towards value-based care. Our quality consulting team works to maximize your earning potential in VBC arrangements like Merit-Based Incentive Payment System (MIPS). 

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How to Pick Which Insurance Companies to Contract With 

For new NP practices, payer contracting can be a challenging but essential process. Establishing relationships with payers is critical to ensure the practice can generate consistent revenue and attract new patients. However, the payer contracting process can be overwhelming, as it involves navigating complex contract terms, reimbursement rates, and credentialing requirements. 

We start by researching and analyzing the payers in your area to determine which payers suit your practice. We consider factors such as the payer’s coverage area, reimbursement rates, and patient demographics. 

Once the contracts are in hand, the terms should be reviewed with our NP business consultants and your legal counsel. Be sure to carefully review the length of the contract, termination clauses, and exclusivity clauses. 

Additionally, it is advisable to review the telehealth policies of each payer if your practice will be providing telehealth alternatives alongside in-person visits. 

Full-Service Payer Contracting for NPs  

With the NP Advantage Solution Suite, insurance contracting for nurse practitioners is a comprehensive service. By working with one vendor, you have the advantage of transparency in the process and cohesion across practice operations. 

When you work with our team, you benefit from: 

  • Specialization in credentialing for nurse practitioners entering private practice and support for NP credential renewals. 
  • Decades of experience in payer contracting, contract negotiations, and reimbursement for nurse practitioners.  
  • Custom EHR for NPs that supports capturing payer contract-specific data related to procedures, evaluation, and management. 
  • Support to maximize commercial payer and Medicare reimbursement with billing and coding for nurse practitioners.  
  • Increased office visits by promoting accepted insurance on your medical practice website.  

If you plan to accept insurance, payer contracting for nurse practitioners is essential to opening and operating your NP-led practice. Depending on your NP specialty, geographic location, and care setting, payer contracting can be incredibly difficult and tedious. Approaching the payer contracting process with tenured professionals simplifies payer contracting for NPs and helps increase practice profitability.