Are you Operating in Plain Sight but Still Overlooked?

The Situation

A retina specialist practice in the southwest wanted to expand outside of their local market. They were working with a small internal practice management team but their impact on payer relations was minimal and increasingly frustrating.

In the process of renegotiating outdated contracts with existing payers, they felt that their value wasn’t being conveyed even after numerous conference calls and email exchanges. They needed a partner that understood the industry and could make strategic recommendations to take them to the next level.

According to their leadership, to truly grow they were going to need help beyond the current team’s capabilities. After an initial consult with our team, the CEO decided that it was time to develop a partnership with Tribunus Health.

The Solution

Within weeks of the onboarding, a competitive analysis was performed using our price transparency tool and target reimbursement rates for key payers and codes were identified.

Leveraging our network of key payer contacts across the country, the Tribunus Health team reached out to both current and prospective payers and the client began seeing progress.

Tribunus Health developed a prioritized strategy with the client’s leadership team to increase reimbursement rates and earn network status in new locations, increasing the number of prospective lives covered and gaining the opportunity to serve new patients outside of their local market. 

The Result

Tribunus Health delivered a strategic plan backed by accurate competitive data
and industry expertise.

This integrated effort resulted in their expansion into new locations, dramatically increasing their number of lives covered.

Additionally, Tribunus Health assisted the client through renegotiation with a national payer, moving their reimbursement rates from 40% of Medicare to 80% of Medicare rates, expecting to recognize at least $500k in new revenue annually.