Simplified Payer Contracting Solutions for Healthcare Organizations

Empowering your practice to succeed in payer contract negotiations

Your Practice Deserves a Payer Contracting Strategy That Works

Prosper Beyond is a woman-founded boutique consulting firm specializing in payer contracting solutions for healthcare providers of all sizes, including medical practices, ambulatory surgery centers, ancillary providers and more. Through payer contracting comprehensive support and consulting, we offer contract assessments, negotiation support, and strategy development to help providers thrive in a value-based healthcare ecosystem.

Known for our collaborative approach, we believe in fostering strong, long-term relationships between providers and payers. Our approach is different — we prioritize your organization’s long term success, simplicity and value ensuring providers receive personalized support from subject matter experts with payer-side experience. We are committed to empowering healthcare providers by helping them navigate the complexities of contracting to achieve sustainable growth.

Payer Contracting Full Support

If you do not have the time, expertise and tools to create and deploy a comprehensive payer contracting strategy — this product is for you!

We work closely with your practice to develop a comprehensive and tailored payer contracting strategy, offering end-to-end support from initial assessments to contract negotiations. Our collaborative approach ensures that we align with your team’s goals, identifying where you are on the payer contracting continuum and mapping out a clear path to success.

Payer Contracting Consulting

Do you have a resource ready to dive into payer contracting but need a sounding board? Or wish you had a mentor to navigate through contract negotiations? This product is for you!

Whether you need assistance with a current state assessment, strategy development, or implementation, our specialists work closely with you to create a tailored approach that fits your unique needs. Work side-by-side with our team to ensure your practice is well-positioned for long-term success.

About Prosper Beyond

Payer contracting is one of the most complex business processes for healthcare organizations. It is very difficult for healthcare providers to navigate and many quit before they start. Achieving more favorable contracts requires resources, time, and industry knowledge your team may not have. We are here to help.

Our Why

We are passionate about supporting healthcare organizations in deploying successful, collaborative, comprehensive payer contracting strategies.

Our Vision

We want to be your long-term payer contracting partner, supporting your organization in creating mutually beneficial and fiscally responsible collaborative relationships with payers.

Our Values

TEAMWORK

SIMPLICITY

INTEGRITY

COMPASSION

COMMITMENT

Hear from our clients

"We chose Prosper Beyond for assistance with our insurance negotiations because they were recommended to us by our peers. I have to say they did a great job, were very easy to communicate with, very professional, and definitely got the job done. Our negotiations were quite successful, and I would highly recommend them!"

Charity F. McConnell, MDFranklin Dermatology 

"As a practice manager with experience in organizations without a vigilant payer contract consulting "partnership" and now two years with Prosper Beyond, who does an outstanding job with us on our behalf, I can say without reservation that Prosper Beyond is a value-added beyond compare. I can't imagine medical practice management without such a partner."

John YeatmanHendersonville Pediatrics

“Working with Prosper Beyond has been a game-changer for us. Their expert guidance has been essential to helping us navigate the challenges of contract negotiation with ease and confidence. They've brought fresh ideas, practical solutions, and a highly professional approach that’s made a real difference.”

Sommer SmithChief Administrative Officer, Great Lakes MSO LLC

"Prosper Beyond has been very good with keeping us informed on a monthly basis and even encouraging us to be confident in our services and value. I would not hesitate to keep them in our tool box. I am looking forward to a long relationship with what we consider are 'experts' in contracting with insurance companies."

Melissa H. WhitePractice Administrator, Newton Family Physicians, P.A.

"Prosper Beyond is a great value to us as an independent practice. Their positive approach has been incredibly effective in helping us in marketing our group and forging new relationships with our payers. Their expertise and experience has not only helped us with contracting and exploring new payment models, but also in communicating and resolving issues that have been impediments to our growth. Working with Prosper Beyond keeps us moving forward in this increasingly challenging environment. I recommend them without hesitation."

Anne HillGastroenterology Associates of the Piedmont, P.A

"The Prosper Beyond team have been amazing to work with. Tasked with renewing our contracts, their approach was methodical and professional. They assessed our initial needs, developed a comprehensive strategy to create a value preposition, and engaged the appropriate reps. When communication with the reps stalled they quickly escalated up the chain. All along they kept my team informed of all the interaction with the payers and developed strategies to counter propose. Would not hesitate and wholeheartedly recommend using for future negotiations."

Pedro TroyaBay Area Endocrinology Associates 

"Since our Medicare Quality Payment Program journey began four years ago, Prosper Beyond has been an essential partner, contributing positively to our successful performance. From the initial organizational readiness assessment, to the engaging on-site stakeholder workshops, combined with regular check-ins and annual strategic planning-we could not have achieved our high-score outcomes in our MIPS performance years without their key partnership!"

Christine N. JohnstoneVice President Quality & Process Improvement | Eisenhower Health

"Prosper Beyond promised to help us obtain insurance payer contracts that were more appropriate for the kind of care we provide and the results they achieved were beyond our expectations! They stated that they would not promise something they couldn’t deliver and their relationships with third party payers made all the difference for us in my opinion. My physicians are extremely pleased with our outcomes and I highly recommend Prosper Beyond's services!"

Christina B. Young, MBA, CMPEAdministrator | Cabarrus Eye Center

"Working with Prosper Beyond has been an excellent engagement for our practices. Doral and her team have all of the skills, knowledge and experience to support their clients through payer negotiations and revenue cycle optimization. They have been effective at improving our rates with payers and have also taught our internal team about the payer contracting process. We look forward to working with them for many years to come."

Zach Levin, CPA Mountain Area Health Education Center

"I am writing this letter to recommend the excellent services of Prosper Beyond. The Propser Beyond team has been working with Kids Central Pediatrics for over a year, providing their services for provider credentialing and insurance contract negotiation. Prosper Beyond answers all my questions, explain things when I do not understand, and keeps me updated on Kids Central Pediatrics contract negotiations and provider credentialing progress."

Tonya ThomasKids Central Pediatrics

"ProsperBeyond has led multiple managed care contract negotiations for our organization. We are a multispecialty group with approximately 60 providers, and complex agreements. The professionalism, experience, and knowledge base of ProsperBeyond's staff is exceptional. The team spent quality time understanding our organization and created a professional value proposition that allowed us to communication our strategic advantages to the managed care organizations. Communication during the negotiation process is very thorough and timely. One of the key success factors of working with ProsperBeyond is that the team fosters relationships between our organization and the managed care organizations. The negotiation process is tedious and time consuming, but ProsperBeyond goes above and beyond, representing our organization like it is their own."

Christie Strong, CMPE Dickson Medical Associates

"Prosper Beyond has become a vital part of my revenue team. All the state-of-the-art billing and collections practices fall short if one isn’t benefiting from an optimized fee schedule. They have deep experience and are skilled at knowing when and how to negotiate improved third party payer contract terms and fee schedules without damaging relationships. Their periodic client status reports assure that follow-up- actions are done, including those assigned and not yet completed by the practice administrator. Furthermore, the team at Prosper Beyond is very generous with sharing their expertise so that not only are managed care contracts improved but so is my skill level. My practice and I have benefited immensely from our partnership with Prosper Beyond."

Michael J. BuncherHendersonville Pediatrics

"The team at Prosper Beyond was mission critical in improving our insurance cycles for both Dermatology and Plastic Surgery. They were able to elegantly elevate our processes and improve our ability to treat patients. I recommend them without any reservation, and I intend to continue to use their counsel moving forward."

Alan Durkin, MD, MSBoard Certified Plastic Surgeon & Medical Director | Ocean Drive Plastic Surgery and MedSpa

"The team at Prosper Beyond have been instrumental in strengthening our reimbursement position with all major payers. Their strategic focus is clear. They are professional, knowledgeable in the industry and have solid connections across the nation. We have developed a strong working relationship with them and envision a long-term partnership with Doral and the Prosper Beyond team!"

Tara JacobsonPractice Administrator | Grand Junction Gastroenterology

"As a business owner of a small private practice, I must be careful where to spend my limited resources. The team at Prosper Beyond has been a great investment. They have been critical for negotiating better reimbursements. In addition to being effective, it is a delight to work with them."

Dr. Julia Warren-UlanchCreedmoor Centre Endocrinology

"Propser Beyond is a very insightful and effective advisor on Revenue Cycle Management opportunities. They have a unique ability to deliver findings and recommendations in clear, actionable language. Definitely would retain their services again."

Chris CarneyFormer CEO | Diamond Healthcare

"I have known the leadership at Prosper Beyond for approximately 20 years, most recently as a representative for physician practices across the negotiation table. They are extremely astute in all aspects of managed care contracting and negotiation. The team is intelligent, professional, strong communicators and a stern negotiators. You will find that them is very knowledgeable in various forms of Value Based Contracting and collaborative arrangements. What impresses me most is their ability to keep progressively knowledgeable in the current healthcare market and her dedication to their clients."

Elaine C. GuthrieDirector | Carolinas Contracting — Cigna

"The MACRA Readiness Assessment was very valuable for WNC Dermatological Associates. It’s the MACRA ‘cliff notes’ in practical terms that helped us understand the Quality Payment Program, identify the financial impact of the program and validate our measure selection for MIPS. We also gained insight and guidance on how we can work on ‘cost’ during 2017 through the Quality and Resource Use Report (QRUR) analysis."

Rocky Bacelieri, MDWNC Dermatological Associates

"I wish to thank Prosper Beyond for the professional help you provided Lake Norman Pathology with auditing the collections for our practice which you provided in the past. We also wish to thank you for your help negotiating managed care contracts. When we have a similar need we will certainly contact you."

Edgar O. Hartle MDAssociate Medical Director | Lake Norman Pathology

Meet our Founder, Doral Jacobsen

Prosper Beyond was founded to help healthcare providers navigate the complexities of today’s healthcare industry, with a focus on next-generation payer contracting. The firm’s seasoned advisors provide practical, real-world experience and expert guidance to help practices thrive in a value-based environment.

Led by Doral Jacobsen, MBA, FACMPE, a healthcare consultant with over 20 years of experience, Prosper Beyond brings expertise in contract negotiations and payment reform. Doral, a national speaker and author, is dedicated to helping providers maximize their revenue and build stronger payer relationships.

Case Study

Prosper Beyond revamped payer contracting for an FQHC, renegotiating outdated contracts and transitioning to FQHC-specific methodologies. By analyzing 24 contracts, increasing reimbursement rates, and securing multi-year agreements, Prosper Beyond delivered over $1.1 million in added commercial revenue, enhancing financial growth and payer relationships.

Listen — The Situation

Federally qualified health center (FQHC) had not renegotiated payer-contracts in over 10 years. The group needed to migrate existing Medicare Advantage contracts and Medicaid contracts to FQHC methodology and also request increases from payers for commercial products. Additionally, the group needed to address below market behavioral health contract rates as well as dental network reimbursement.

Solve — The Strategy Deployed

Analyzed contracts (24 in total) in detail creating a comprehensive assessment outlining contract value to the organization, administrative burden implications and a roadmap for renegotiation strategy. Created a succinct and impactful value proposition outlining key areas pertinent to each payer and met with payers to relationship build and work on increasing contract value in terms of rates and decreasing administrative burden. Approached all strategically impactful payer contracts and renegotiated rates successfully securing many multiple year agreements with the majority payers and identified new value-based programs available to the group. The group also terminated a few agreements that were underperforming when payers did not meet reasonable market rates.

Change — The Impact

Annual economic impact = over $1.1 million estimated increases to commercial reimbursement rates. Successfully migrated Medicare Advantage contracts to FQHC arrangements. Negotiated favorable contract terms with commercial payers, increasing filing limits, securing favorable amendment language and more. We identified new value-based arrangements and assisted in developing communication pathways with payers to continue working on relationship building and collaboration opportunities.

Ready to streamline your payer contracting process?

Schedule a call with our team to learn more about how we can help you navigate the complexities of contracting to achieve sustainable growth.