Payer Management

Brault can provide your Practice with detailed contract management data and negotiation strategies to arm you with all the tools necessary to achieve a profitable contract. Our Practice Solutions portal produces reports that allow us to monitor the reimbursement performance of each contract, to ensure that the negotiated rates are being paid. The system provides account and charge detail, which can pinpoint any underpaid charges and notify our A/R team for tracking through the appeal process. And, as an added value to our clients, Brault’s Payer Compliance Officer oversees all payer communications related to contracting and fair-payment practices.

Provider Enrollment

Accurate, timely enrollment is key to ensuring optimal revenue and cash flow. Once payer contracts are identified, our Provider Enrollment Department enrolls the group practice and all providers where required, including government programs. You can finally stop chasing providers for documents and signatures because Brault does all that for you for each provider.

Compliance Monitoring

Our Payer Compliance Department, led by a practicing health care attorney, is able to achieve remarkable results by knowing and applying the precise payer rules for each contract and, when abusive payer activities are identified, preparing these cases for litigation at the discretion of each Client.

Contract Negotiation

Brault can provide your Practice with detailed contract management data and negotiation strategies to arm you with all the tools necessary to achieve a profitable contract. Collecting and maintaining years of detailed claim data, analyzing it and negotiating directly with both contractual and non-contractual payers are just some of the reasons why our clients enjoy significantly higher reimbursement rates than would otherwise occur.

And as each payer contract renewal period approaches, we use strategic-impact modeling to determine your strongest negotiating position (plus favorable alternate positions). We also assess the payers’ past performance, including their record of honoring agreed-upon payment and other terms of the contract, in order to leverage all available data points that may impact your Group’s reimbursement.

Litigation Support

In recent years, Brault has supported clients in filing more than 30 lawsuits against different payers who have engaged in unfair payment patterns. In one landmark case, which resulted in a seven year trial and appeal process (Bell vs. Blue Cross of CA), Brault provided the litigation support that ultimately assured the right for physicians to file suit against regulated payers for unfair payment practices.

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