Provider Consulting

What we provide

A significant amount of costs, in terms of time and resources, are associated with the effective management of existing and new contractual relationships with third party payers. Blakemore Consulting relieves office staff of the need to manage these contractual relationships and focus on their primary responsibilities. In many cases, this includes patient care, patient relations, filing of claims, and accounts receivable. Blakemore Consulting ‘s services ensure best practices are followed, without the need to reinvent existing day-to-day operational workflows, and bring additional revenue opportunities to the organization.

Utilizing a Systematic Approach to Maximizing a Provider’s Profitability

Strong, market acceptable, third-party payer contracts are integral to the success of any provider practice as they are the primary revenue stream into the organization. Many providers, or provider groups, enter contractual relationships without fully understanding the nature of their existing patient mix and the complexity behind the third-party payer contracts in which they enter. A systematic approach is required to make informed contractual decisions in order to maximize the overall profitability of the organization. Blakemore Consulting has built a reputation to effectively manage these daily administrative tasks while providing long term solutions to the practice. 

Our approach includes:

  • Practice “snapshot”
  • Analysis of patient and payer mix
  • Evaluation of coding / billing practices
  • Network payment compliance reporting
  • Leveraging existing / strong carrier relationships
  • Contract–to–Contract reimbursement comparisons
  • Development of fee schedule or charge master structures
  • Regular feedback regarding external industry activities
  • Credentialing and/or re-credentialing functions
  • Contract verbiage review supported by alternative language
  • Extensive contracting experience due to prior network development responsibilities
  • Third party payer contracting strategies specific to practice utilization patterns and market dynamics
  • Financial analysis and reimbursement modeling to support pre-approved network negotiation and/or renegotiation efforts
  • Marketing services to provide increased patient volume, larger referral base, direct employer relationships, and patient steerage into “preferred” third party agreements