Signed rates are promises. Collect on every one of them.
You negotiate the rates; payers administer them through policies and programs that quietly pay less. We work for managed care, reimbursement, and payer contracting leaders to close that gap: contracts loaded and verified, variance recovered, payer behavior documented at claims level, and findings shaped into leverage for the next table.
7 of top 20
U.S. health systems served
32M+
Coding charts processed annually
28M+
A/R claims managed annually
Because a signed rate is only a suggestion until it is enforced.
Revenue cycle support for managed care, reimbursement, and payer contracting leaders treats the contract as a living instrument: rates and terms loaded into expected reimbursement and tested, payment variance worked to recovery instead of aging into forgiveness, policy bulletins quantified before they quietly reprice you, and payer scorecards built from claims detail, so joint operating committees and renewals start from your evidence.
Every contract term loaded and enforced
Underpayments recovered, sources documented
Negotiations armed with claims-level proof
Support across the workflows that turn payer agreements into realized reimbursement.
Front-office, mid-office, and back-office support connects the operational evidence behind payer performance. Coverage, authorization, documentation, coding, claim, denial, remittance, and underpayment signals show where contract intent is not reaching cash. Contract strategy and the negotiating chair stay yours; we make sure you arrive armed.
Front-office
Payer rules executed at intake - terms honored from the first touchpoint.
- Patient Access Management
- Eligibility and Benefits Verification
- Prior Authorization
- Registration QA and Demographic Accuracy
- Insurance Discovery and Coverage Discovery
- Financial Clearance and Counseling
- Price Transparency and Patient Estimates
Mid-office
Documentation aligned to payment policy - fewer footholds for downgrades.
- Medical Coding
- Clinical Documentation Integrity (CDI)
- Charge Capture Optimization
- Revenue Integrity and Leakage Prevention
- Coding Audits and Quality Assurance
- Risk Adjustment and HCC Coding
- Computer-Assisted and AI-Enabled Coding
Back-office
Variance worked claim by claim - contracted dollars actually collected.
- Claims Editing and Clean-Claim Validation
- Denials Management and Appeals
- Accounts Receivable Follow-Up
- Complex AR Recovery
- Underpayment Recovery and Payer Variance Resolution
- Payment Posting and Reconciliation
- Extended Business Office and Co-Managed Operations
Four leaks between the signature and the deposit, sealed.
Rate and term integrity
Payment Posting and Reconciliation · Underpayment Recovery and Payer Variance Resolution - so payments get tested against loaded terms and every shortfall becomes a finding, then a recovery.
Denial leverage
Denials Management and Appeals · Prior Authorization - so denial and auth patterns get worked, quantified by plan, and carried into your payer meetings.
Level-of-care defense
Clinical Documentation Integrity (CDI) · Risk Adjustment and HCC Coding - so severity and level of care hold up when plans repay less than the record supports.
Value-based settlement
Coding Audits and Quality Assurance · Charge Capture Optimization - so incentive and shared-savings settlements get verified against your own data before you sign off.
One operating model. Three pillars. Every engagement.
Expertise-led
Revenue cycle and reimbursement specialists work inside payer workflows and account evidence.
- Expertise across eligibility, authorization, claims, denials, payment posting, underpayments, and A/R
- A named lead connecting findings to reimbursement and payer priorities
- Capacity aligned to payer volume, variance, backlog, complexity, and recovery value
Technology-powered
Technology-enabled services make payer performance traceable, visible, and actionable.
- Work prioritized by dollars at risk, payer, variance, timely filing, and next action
- Automation for validation, reconciliation, variance detection, and evidence assembly
- Dashboards connecting expected reimbursement, payment, denials, recovery, and payer action
Operationally-governed
Governance connects payer findings to ownership, recovery, escalation, and contract strategy.
- Agreed definitions, assumptions, baselines, targets, data sources, and cadence
- Root-cause review by payer, plan, site, service line, denial, and variance
- Closed-loop action for recovery, escalation, workflow change, and negotiation evidence
Our Vision
Open Accountability: Taking responsibility without taking control.
Payer strategy stays yours, undiluted. Contract terms stay confidential, data stays in your control, and scope flexes on your call, on your systems or through RevAmp. Recoveries and reporting commitments go down in writing, the math shows claim by claim, and the deposits argue for renewal.
Contract yield
Actual payment against modeled rates, by payer and term
Variance recovery
Underpaid dollars identified, pursued, and returned
Days to pay
Payer payment speed measured against contract terms
Term compliance
Payer adherence to auth, filing, and payment obligations
Downgrade rate
Claims paid below billed level of care or severity
Why Us
Replace disconnected payer data with First-Pass Performance.
When contract terms, reimbursement models, revenue cycle operations, and payer recovery sit in separate workflows, leaders see the gap only after denials, underpayments, and aging accumulate. First-Pass Performance connects payer requirements to daily execution, validates expected payment, and turns variance into recovery and strategy.
Rework-Powered Cleanup Machine
Our First-Pass Performance
Contract translation
Terms remain in models and documents while operational rules drift.
Terms are translated into defined rules, assumptions, owners, and validation.
Payment visibility
Variance appears after aging accumulates across payer and account queues.
Expected and actual reimbursement are compared early enough to act.
Payer escalation
Issues are raised case by case without a consolidated evidence trail.
Recurring behavior is quantified by payer, plan, service line, and financial impact.
Recovery
Underpayment work runs separately from contracting and operations.
Recovery findings feed workflow correction, payer action, and negotiation strategy.
Accountability
Teams report activity while contract yield ownership remains unclear.
Agreed work has a named owner, shared measures, cadence, and visible action.
Extend performance across connected outcomes.
Revenue cycle thinking for leaders who need fewer surprises.
Explore Vee Healthtek perspectives on the forces reshaping revenue cycle performance, healthcare operations, technology adoption, and financial resilience.
Bring one payer performance pressure point. Leave with a clearer action path.
Use a 30-minute working session to examine one issue such as contract yield, reimbursement variance, payer denials, authorization behavior, underpayments, settlement visibility, or inconsistent payer performance. Bring the contract question, payer view, queue, variance report, or KPI that concerns you. We will map where the gap enters, what support could own, and how action should be governed.
Frequently Asked Questions
How can managed care, reimbursement, and payer contracting support fit into your operation?
Which revenue cycle functions can support payer contract performance?
How do you connect payer contracts to actual reimbursement?
How do you help identify and recover underpayments?
How can operational data strengthen payer negotiations?
How do you use automation and analytics in payer performance workflows?
Which managed care and reimbursement KPIs can we govern together?
What should you bring to an initial working session?