Payer & Provider Disputes

PayrAdvisors handles differences between Payers & Providers

Even with the best contracts and strongest relationships, disputes between payers and providers can—and do—happen. At Payr Advisors, we provide experienced guidance and hands-on support to navigate disputes efficiently, protect your interests, and recover what’s owed.

From informal escalations to formal appeals and regulatory complaints, we bring a measured, strategic approach to even the most contentious issues.

in claims data across all states and specialties!

When Things Go Off Track, We Step In

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Identifying the Root Cause

Every dispute has a story. We dig into the details—whether it’s a systemic denial pattern, misapplied contract language, payment inconsistency, or network access issue—to pinpoint the underlying problem and assess the most effective path forward.

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Facilitating Resolution

We start with diplomacy. Our payer relationships often allow us to resolve issues directly, avoiding legal escalation or prolonged appeals. We coordinate calls, draft position letters, and guide your internal teams on how to document and respond effectively.

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Escalating When Necessary

When informal resolution fails, we’re ready to escalate: Filing formal appeals with payers, Submitting complaints to Departments of Insurance (DOI), Engaging third-party dispute resolution or legal teams when required. Our goal: resolve the issue, recover revenue, and preserve your payer relationships when possible.

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Common Disputes We Handle

At Payr Advisors, we act as your advocate, your strategist, and your buffer—so you can stay focused on care delivery while we manage the conflict.

Unjustified claim denials
Rate discrepancies or underpayments
Credentialing or network access disputes
Term violations or retroactive changes
Out-of-network payment conflicts
Delayed or incomplete payments

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Durango Infusion, LLC

“A decade ago I began a multi specialty practice. Through the years I have used a variety of contractingservices. Never before have I worked with someone so efficient, attentive, insightful, and effective as PayrAdvisors. Hands-down I would recommend them to anyone. They are worth having on your team.”

Dr. Moss Fenberg, MD – President & CEO

ENT Physicians of North Mississippi

“Sam and his team have been transformational to our practice. They successfully negotiated all of our
major contracts far beyond what had been done by other preceding counsel and anything we could have
envisioned. They are truly a remarkable team who I could not recommend more highly”.

Dr. Matthew Stevens, MD – President & CEO

Regeneration Psychiatry

“PayrAdvisors has been an important partner for our group practice. Their team’s expertise and guidance
have helped us negotiate good contracts that we would not have been able to achieve on our own and
that have allowed us to pursue our mission to provide high-quality, accessible mental health care to our
community”

Dr. Jobert Poblete, MD – Partner

FlexCare Infusion Centers

We have had a great experience working with PayrAdvisors. Having worked with three other companies for contracting/contract negotiations in the past, PayrAdvisors is the first who truly understand our industry and how to successfully negotiate with payers. We have seen a 10x ROI in under a year.”

Callie Turk, Chief Operating Officer

Cancer Care Northwest

“Samuel and his team partnered with us as we began updating our payor contracts. PayrAdvisors spent time on the front end of the project to learn goals and the personality of our group. We have been impressed with their knowledge of Oncology and thorough analysis of our contracts and proposed contracts. We are pleased with their ability to help us get our contracts updated and further solidify our partnership with the payors in our region.”

Rod Emerson – CEO

Urgent Team

“We engaged Sam and his team to help us navigate an increasingly complex and contentious environment negotiating contracts with payers. I was familiar with Sam through a separate company where I serve on the board, and was aware of the value Sam brings to payer negotiations. PayrAdvisors quickly became an extension of our team. They provided valuable strategic and tactical advise as well as technical contract review. PayrAdvisors is a valuable partner for any healthcare services company that is facing flat rate increases in an environment with tremendous inflationary pressures”.

Rudy Blank – CFO

BASS Autism

“PayrAdvisors succeeded where others have failed. Through the very hard work of Trystan King and Samuel Barnes, Bass ABA Therapy was able to successfully renegotiate our major payor contracts. They always communicated back to us in a very timely manner. These guys are very professional and courteous with the insurance payors. They preserved our long-term relationship with our payors but still achieved excellent results.”

Dave Morell – CEO

BrookWell Infusion, LLC

“Having the right payor relationship development and contracting strategy is critical to the success of any provider group. PayrAdvisors came along at just the right time for our group. Sam Barnes and his colleagues are highly connected with decision-makers from key payors and have an exceptionally strong and positive approach to payor negotiations. They also provide valuable counsel on developing an overall payor strategy, and work with some of the largest healthcare groups and system in the nation. I heartily recommend PayrAdvisors to any healthcare group looking to improve their payor relationships and contracts.”

Joseph Huntsman – Founding Partner

Contact Us Today to Learn More About How We Can Optimize Your Payer Negotiation Strategy.

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We understand the unique challenges that providers and their staff face, which is why we are dedicated to offering exceptional services tailored to your individual needs.

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