Become the next
Aroris success story.
These are just a few of Aroris'
success stories on behalf of
healthcare providers nationwide.
A Midwest Behavioral Health Group
Turning a loss into a 20-point victory.
Aroris uses its insider expertise to help a behavioral healthcare provider reverse a rate decrease.
The client sought Aroris' expert opinion on one of its largest payer's latest reimbursement rate contract before it would sign the agreement. Upon review, Aroris discovered the client would receive 8% less than the prior agreement executed through a regional provider and recommended they not sign the contract.
Through some digging, Aroris learned before it was officially announced that a new regional provider would take over. Moving quickly, Aroris conducted an in-depth analysis of the provider's reimbursement history and regional data to make the case for an upward rate adjustment.
Aroris earned the client a 12.9% increase over the prior rate, totaling more than a twenty-point rate swing from the proposed agreement. Upon execution of the contract, the new regional provider became the client's highest-ranked payer.
A Northeast Orthopedic Group
Doing what thought couldn’t be done.
Aroris earns increases on previously non-negotiable payer contracts for a provider with multiple entities.
This highly regarded health group comprises four entities: an orthopedics practice, two surgery centers, and an anesthesiology group. Each entity individually contracts with a portfolio of payers. Having recently assumed responsibility for negotiating payer contracts, the client's time-stretched practice administrator sought Aroris' help navigating all of the complexity.
Upon analyzing each payer contract for all four entities, Aroris identified eleven payer contracts eligible for negotiating new reimbursement rates. In the past, many of these payers told the provider that their reimbursement rates were non-negotiable. However, armed with the latest market data, a determined spirit, and a compelling case that preserving the client's viability was critical to the well-being of its community, these once intractable payers agreed to make rate adjustments.
So far, Aroris has successfully negotiated rate improvements on six contracts, earning an average 10.5% rate increase. Negotiations continue with the remaining payers.
A Midwest Multi-Specialty Group
Saving a relationship for a community’s good.
Aroris makes the case that reimbursement rate adjustments were needed for a provider to stay in the provider’s network.
Facing the prospect of terminating their largest payer contract due to inadequate reimbursement rates, a Midwest multi-specialty group looked to Aroris to make a last-ditch effort to preserve the relationship.
Aroris started by first understanding the pain points of both the provider and the payer. Then, it dove deep into the data of their shared history and benchmarked the findings against market-level figures for their region. This work manifested in a compelling business case that clearly demonstrated reimbursement revenues needed to align with the value the practice provided to its patients and community.
Aroris successfully negotiated an 11% reimbursement increase for the practice. More importantly, it preserved the relationship, ensuring high-quality care, greater access, and more options for the members of their shared community.
A Northeast Anesthesiology Group
Transforming a shortfall into a windfall.
Aroris leverages digital technology and analytical expertise to spot reimbursement revenue opportunities.
A Northeast anesthesiology group faced a revenue shortfall due to CMS' 4.4% across-the-board reimbursement rate cut for the specialty. They sought Aroris' help to fill the gap.
Leveraging its proprietary digital platform, Aroris' experts scoured the contracts and reimbursement history of all the group's commercial payers to spot revenue opportunities. Aroris then assembled rational cases for rate increases across their roster of insurers. Expert negotiators then relentlessly pressed those cases to a host of positive outcomes.
Aroris successfully negotiated a cumulative 14.3% reimbursement rate increase across their commercial payers, fully offsetting the CMS rate reduction and then some.
Northwest Pain Management practice
Negotiating a profitable future by engaging proactively.
Aroris expertly counters drastic fee changes, securing fair reimbursements and driving significant revenue growth for healthcare practices.
A large payer proposed a complete fee schedule change, which, if enacted, would leave this pain management practice experiencing an 80% reduction in reimbursement on a highly utilized code. Sensing an urgent and complex negotiation with the payer, Aroris was asked to help.
Aroris stepped in to lead the negotiations and worked with the payer to carve out the highly utilized code to be reimbursed at a higher, fair market rate. In parallel, Aroris showed how the payer was underpaying in reimbursements in other areas and achieved increases on additional codes that were strategically important to the practice's growth.
Aroris earned the client a 29% revenue increase, resulting in this payer aligned with fair market reimbursement rates.
Southwest Cardiology Practice
Appealing to the payer’s competitive needs.
Aroris transforms complexity into opportunity, ensuring fair compensation and superior patient care in healthcare.
The specialty practice operated within 15 individual contracts with the same payer, all with unique terms, conditions, and nuances. It was difficult for the practice to assess the merits, compliance, and performance of each contract, which limited its ability to proactively engage the payer and negotiate for better terms.
Aroris’s analysis of the individual contracts indicated the payer was reimbursing codes at 4% less than market average. Therefore, Aroris’ objective with the payer was twofold: (1) Convince the payer to consolidate the 15 individual contracts into one group contract to simplify the administration effort. And (2) promote and advocate the unique advantages of the specialty practice and why increased reimbursement rates above the market average were essential to the payer’s competitive offering in that market.
After multiple conversations over 6 weeks, the payer agreed to a group contract and proposed a multi-year deal to achieve the desired rates. The result was an agreed 9% revenue increase, resulting in an additional $142,288.
Midwest Optometry and Ophthalmology Practice
Designing alternative solutions to achieve win/win results.
Aroris champions equitable healthcare, maintains fair fee schedules and enhances revenue for healthcare providers.
This specialty practice operates a clinic and ambulatory surgery center (ASC) employing both optometrists and ophthalmologists. A significant payer was proposing to break the consolidated fee schedule into two separate fee schedules, which would result in a 30% decrease in reimbursements to optometrists. Aroris was engaged to help negotiate a better outcome with a determined payer.
Aroris’s analysis revealed the payer had been reimbursing the clinic and ASC services below market average. Aroris’ goals were: (1) engage the payer and oppose the fee schedule changes through a compelling business case. And (2) negotiate for fair-market reimbursement levels for the clinic and ASC.
Over the course of 18 weeks, Aroris engaged with the payer to identify alternative solutions to achieve win/win outcomes for both parties. The payer was reluctant to maintain the one-fee schedule; however, after persistent phone calls, emails, and robust discussions, the payer agreed to keep the one-fee schedule, thus avoiding the decrease in revenue. Additionally, Aroris achieved an 11.3% revenue increase for the ASC and a 12.9% revenue increase for the clinic over multi-year contracts.
Southwestern Behavior Health Provider
Not settling for the status quo.
Aroris detangles complexity to focus on what matters most.
A provider making lasting addiction recovery a reality for many Texans sought Aroris’ help as it entered a new contract term with a major payer. Even though the payer’s current reimbursement rates were slightly above market average, they still didn’t align with the provider’s low-patient population, high-touch care model.
An existing rate structure that rolled up all CPT codes into four distinct categories made it challenging to paint a complete reimbursement picture. Yet, armed with analytic tools and expertise in the specialty, the Aroris team modeled which of the rates provided the most significant revenue impact and made it the strategic focus of the negotiations.
Taking about six months from initial contact to closing, Aroris earned the provider an 8.3% overall reimbursement rate increase with the payer. Additionally, Aroris negotiated more favorable contract language intended to generate greater administrative value for the provider over the life of the agreement.
Southeastern Orthopedic Group
Correcting an unfair deal.
Aroris persistently appeals to good faith and fair dealing to earn a more equitable payer contract.
Midway through a three-year contract and amid runaway inflation, a payer's low reimbursement rates were causing an untenable strain on the provider's business. The contracted rates remained the same for each of its three years, not accounting for inflation in years two and three.
Aroris made it clear to the payer that they must adjust their rates to ensure the practice's viability. Twice, the payer refused to increase reimbursement rates. Employing an unrelenting will and an appeal to good faith and fair dealing, the payer capitulated by offering a new three-year deal. Amazingly, the offer didn't include rate increases for years two and three.
It took about eight months, but Aroris' persistence and diplomacy paid off for the provider with a new three-year contract, including rate increases for years two and three. All-in-all, the contract earned the provider a 7.16% increase.