Photo zone · dermatology / clinical
Dermatology

Dermatology Payer Strategy & Negotiation Experts

We help dermatology practices secure fair reimbursement and operational relief through data-driven payer negotiation.

$1B+
In negotiated financial lift
12%
Average revenue lift
7-12x
Average ROI
About us

The Nation's Leading Experts in Payer/Provider Contract Negotiations

We are a relationship-driven consulting firm focused on payer/provider innovation, in-depth market analyses that drive sustainability, and long-term results for our clients.

We bring deep expertise in procedural mix, Mohs and pathology reimbursement, and multi-state market access—helping dermatology groups realign below-market contracts to parity.

Our services

We Manage Your Payer Relationships End-to-End

Our services holistically examine every opportunity for improved reimbursement and market access.

Negotiations & Strategy

Relationship Management

We manage your day-to-day payer communication and escalations, providing dedicated support beyond transactional work.

Negotiations & Strategy

Contract Modeling

We provide data-driven financial modeling for every payer contract, so you know the impact before you sign.

Transparency Data

Payer Transparency Insight

Clear benchmarking shows exactly how your rates compare to the market, revealing negotiation opportunities and leverage.

Transparency Data

Claims Data & Analytics

Identifying underpayments, trends, and revenue gaps lets us recover your lost dollars and strengthen negotiations.

Disputes

Contract Management

We proactively track renewals and amendments, and identify any recoverable dollars tied to denials.

Disputes

Dispute Resolution

We handle end-to-end management of payer disputes, driving effective and timely resolution.

Our advantage

We Understand the Challenges Healthcare Organizations Face

Current Landscape

  • Missing or fragmented fee schedules undermine negotiation leverage
  • Limited market insight into actual payer rates
  • Lack of dedicated contracting expertise and payer fluency
  • Declining reimbursements and rising costs compress margins

Our Solutions

  • Data Diligence We inventory contracts, fee schedules, and amendments to restore complete rate visibility.
  • Transparency Analytics We benchmark your rates vs. market to expose negotiation opportunities.
  • Specialist Team Expert analysts and negotiators manage payer language, structure, and escalations.
  • Revenue & Efficiency Gain Our proven strategies increase practice revenue and reduce administrative burden.
Specialty focus

We Understand the Challenges Affecting Dermatology Groups

Medical vs. Cosmetic Procedural Mix

We benchmark your full procedural mix to surface underpaid medical and surgical dermatology codes.

Mohs & Pathology Reimbursement

We defend Mohs surgery and dermatopathology rates against bundling and downcoding.

Closed-Network Market Entry

We secure network exceptions and in-network access even in closed dermatology markets.

Multi-State Rate Parity

We realign below-market contracts to parity across every state you operate in.

Our strategy

Our Proven Model for Your Success

We craft specific payer strategies tailored to your practice, identifying negotiation opportunities and leverage points that strengthen financial and operational outcomes.

1

Understanding Your Market Position

We use transparency data to compare your rates to the market by specialty, geography, CPT code, and payer & product type.

2

Identifying Your Strengths

Every practice has leverage. We highlight yours: quality metrics, access, outcomes, technology, service lines, and patient experience.

3

Building a Go-to-Market Strategy

We tailor your payer strategy, approach health plans, track progress, and model every proposal.

4

Navigating Complex Negotiations

Routine renegotiation or major escalation, we guide you through terminations, payer pushback, and strategic decision-making.

Case studies

Real Results for Dermatology Groups

Anne Arundel Dermatology

Multi-State Contract Optimization

One of the largest dermatology groups in the Southeast realigned longstanding below-market contracts to market parity, expanding the engagement into an ongoing partnership.

$2.8M
Year-one financial lift
Blue Shield +$1,458,000
Cigna MD +$649,000
UHC TN +$359,000
UHC NC +$273,000
Anthem +$65,000
Illinois Dermatology / Schweiger

Rapid Access in a Closed Market

Secured a network exception and executed a new in-network agreement within 120 days, unlocking downstream commercial and Medicare Advantage improvements in Florida.

+20%
UHC Commercial (over 3 years)
FL Blue +18%
Aetna +11%
Humana +11%
Cigna +10%
Cascade Dermatology & Aesthetics

Targeted Commercial Improvements

Targeted negotiations with Providence and Moda Health drove measurable rate gains across major payers, with Medicaid negotiations ongoing.

+17%
Moda Health
Providence +12.7%
UHC +3.4%
Pacific Source +3.3%
Aetna +3.0%
Our timing

What to Expect From Start to Finish

We provide expert guidance and transparent benchmarks to develop a scalable partnership that grows as you grow.

First 60 days

Discovery & Diligence

Review all practice documents, contracts, fee schedules, amendments, W-9s, and benchmark RCM data.

60–90 days

Engagement Kickoff

Execute the Client Services Agreement, BAA, and NDAs, and invoice for services.

60–180 days

Negotiation Begins

Begin the negotiation process and align with you on strategic goals.

6–7 months

Finalize Offers

Review contract language, rate exhibits, and analytics to finalize offers.

8–9 months

Language & Protections

Negotiate contract language that reduces risk and improves administrative challenges.

9+ months

Execution & Loading

Execute contracts, credential providers, and ensure contracts are loaded correctly.

9–12 months

Monitoring

Track and monitor contracts to ensure rate compliance.

18+ months

Continuous Improvement

Begin assessment on renegotiating contracts still below market rates.

Our pricing

We Win When You Win

Our services are paid on our performance. A modest implementation fee keeps barriers low; the rest is earned only when your reimbursement improves.

Our Contingency Model

  • Low upfront cost A modest implementation fee reduces financial barriers and accelerates onboarding and contract prep.
  • Pay only for results Clients share 50% of the lift only after improved rates are contracted and effective.

Built for Your Structure

  • PE-backed portfolios EBITDA-protective performance fee and portfolio-wide scalability.
  • Small to mid-size practices Far less risk than outsized retainers of $60–250k per month, with access to high-level expertise.
Photo zone · skyline / institutional

Are You Ready to Change the Way You Work With Payers?

Schedule a confidential consultation to see what better payer contracts could mean for your dermatology group.