Healthcare Providers Succeed With Our Expertise

  • 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

  • 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 Yeatman

  • 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, MD

  • 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

  • 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 Hill - https://gapgi.com/

  • 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. Their experience puts you on level playing field with payers to guarantee good outcome. Their service is invaluable for small practices trying to navigate this increasingly complicated landscape. Wish we would have found them sooner.

    Pedro Troya - https://thyroiddoctortampa.com/

  • 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 Thomas - https://www.kidscentralpediatrics.com/

  • "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, MS - Board Certified Plastic Surgeon & Medical Director, Ocean Drive Plastic Surgery and MedSpa - https://www.oceandriveplasticsurgery.com/

  • 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 Jacobson - Practice Administrator - https://gjgastro.com/

  • 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. Buncher - Hendersonville Pediatrics - https://www.hendersonvillepediatrics.com/

  • 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. Johnstone - Vice President Quality & Process Improvement - Eisenhower Health - https://eisenhowerhealth.org/

  • 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-Ulanch - https://www.ccendocrinology.com/

  • 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, CMPE - Administrator - Cabarrus Eye Center - https://www.cabarruseye.com/

  • 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. Guthrie - Director, Carolinas Contracting - Cigna - http://www.cigna.com

  • 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 Carney - Former CEO of Diamond Healthcare - http://www.diamondhealth.com/

  • 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 MD - Associate Medical Director - Lake Norman Pathology - http://lknpathology.com

  • 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, MD - WNC Dermatological Associates - http://wncderm.com/

Value Based Contracting

For a multi-specialty medical practice, our team renegotiated several payer contracts resulting in favorable economic impact constructed on a value based foundation. Our team also resolved several troubling contract language issues that resulted in a positive impact from an operational perspective. Additionally, we have many more payer contacting success stories and a long list of happy clients.

F e e f o r S e r v i c e P e r f o r m a n c e B a s e d B u n d l e P a y m e n t s S h a r e d S a v i n g s S h a r e d R i s k G l o b a l P a y m e n t s L e v e l o f E c o n o m i c R i s k D e g r e e o f P r o v i d e r I n t e g r a t i o n Payer Contracting Continuum

Value Proposition Development

For a large primary care medical practice, we developed an impactful value proposition that supported the group as they worked with payer partners on alternative payment models. This framework clearly articulated how the group compared to peers relative to ‘total cost of care’ enabling the organizations to consider innovative payment models. The result was three-fold: improved payer/practice relationships, movement toward alternative payment model execution and reimbursement to the practice for sophisticated population health investment.

Cost of Total Care
MACRA Readiness Assessment Book Cover

MACRA Readiness Assessments

For this large hospital based health system’s medical practice, our team evaluated their Quality and Resource Use Report data and developed a customized MACRA Action Plan.   Our team provided comprehensive MACRA education, feedback regarding measures optimization and a strategic MACRA Action Plan.  Our team was instrumental in preparing the group to be successful under MACRA and maximize opportunities based on your strengths, capabilities and vision for the future.

Revenue Cycle Process Improvement

For a 40-physician surgery practice with an ASC, performed an initial assessment and subsequent re-engineering of revenue cycle processes including establishing a monitoring system, standardizing policies and procedures for all satellite offices, and staff training resulting in an estimated $2,000,000 in added practice revenue within a six-month time frame.

Front Desk Collections

For an ENT practice client, streamlined front-desk collection activities resulting in reducing “days in accounts receivable” by 26 days and doubling practice front-desk collection revenues. Physician income also increased 35% as a result of successful implementation of best practices.

Dashboard Development

For a hospital system, developed comprehensive dashboards for associated physician practices. Dashboards informed leadership regarding practice performance compared to peers within the region. It included qualitative and quantitative metrics uniquely framing performance demonstrating environmental factors impacting the practice and pinpointing opportunities for improvement.

Operations

Assisted a hospital system with an operational overhaul including organizational structure, credentialing, revenue cycle optimization and managed care contract negotiations. Adjusted collections for their medical group increased over 200% and revenue by 64% within 12 months of project initiation.