Case Studies
Become the next Aroris success story.
Across orthopedics, primary care, surgery centers, behavioral health, radiology, and more, practices use Aroris to find what their contracts are missing, sign the rate they’re owed, and watch every claim until payers actually pay it.
In their words
Project Manager of Care Counseling
Better rates mean better care.
Featured Case Study
+29%Rate increase achieved through proactive negotiation Pain Management Negotiation NorthwestNegotiating a profitable future by engaging proactively.
A Northwest pain management practice didn’t wait for renewal. By engaging proactively with the right benchmarks and the right negotiators, they secured a 29% rate increase ahead of schedule.
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Featured Case Study
Negotiating a profitable future by engaging proactively.
A Northwest pain management practice didn’t wait for renewal. By engaging proactively with the right benchmarks and the right negotiators, they secured a 29% rate increase ahead of schedule.
The Situation
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.
The Action
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 other areas and achieved increases on additional codes strategically important to the practice's growth.
The Results
Aroris earned the client a 29% revenue increase, with this payer now aligned to fair-market reimbursement rates.
+14.3% Anesthesiology NortheastTransforming a shortfall into a windfall.
Aroris leverages digital technology and analytical expertise to spot reimbursement revenue opportunities.
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Transforming a shortfall into a windfall.
Aroris leverages digital technology and analytical expertise to spot reimbursement revenue opportunities.
The Situation
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.
The Action
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.
The Results
Aroris successfully negotiated a cumulative 14.3% reimbursement rate increase across their commercial payers, fully offsetting the CMS rate reduction and then some.
+12.9% Behavioral Health MidwestTurning a loss into a 20-point victory.
Aroris uses its insider expertise to help a behavioral healthcare provider reverse a rate decrease.
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Turning a loss into a 20-point victory.
Aroris uses its insider expertise to help a behavioral healthcare provider reverse a rate decrease.
The Situation
The client sought Aroris' expert opinion on one of its largest payer's latest reimbursement rate contracts before signing 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.
The Action
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.
The Results
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.
+11.3% Optometry/Ophthalmology MidwestDesigning alternative solutions to achieve win/win results.
Aroris champions equitable healthcare, maintains fair fee schedules, and enhances revenue for healthcare providers.
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Designing alternative solutions to achieve win/win results.
Aroris champions equitable healthcare, maintains fair fee schedules, and enhances revenue for healthcare providers.
The Situation
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.
The Action
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.
The Results
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.
+11% Multi-Specialty MidwestSaving a relationship for a community’s good.
Aroris makes the case that reimbursement rate adjustments were needed for a provider to stay in the payer’s network.
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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 payer’s network.
The Situation
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.
The Action
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.
The Results
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.
+10.5% Orthopedics NortheastDoing what thought couldn’t be done.
Aroris earns increases on previously non-negotiable payer contracts for a provider with multiple entities.
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Doing what thought couldn’t be done.
Aroris earns increases on previously non-negotiable payer contracts for a provider with multiple entities.
The Situation
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.
The Action
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.
The Results
So far, Aroris has successfully negotiated rate improvements on six contracts, earning an average 10.5% rate increase. Negotiations continue with the remaining payers.
Become the next success story.
A short discovery call. A look at your contracts and claims. A clear, specific number, like the ones above.
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Find out what your practice is owed.
A short discovery call. A look at your contracts and claims. A clear, specific number, like the ones above.