PayrHealth and Radix Partner to Increase Out-of-Network Reimbursement for Providers

28.01.25 15:15 Uhr

Comprehensive and holistic approach helps providers achieve fair payments and reduce the risk of insurer underpayment

AUSTIN, Texas and LOS ANGELES, Jan. 28, 2025 /PRNewswire/ -- PayrHealth, the industry's leading Complete Payor Management solution, and Radix, the only software-based No Surprises Act Independent Dispute Resolution ("IDR") solution, today announced a strategic partnership to deliver a holistic contracting and reimbursement strategy for healthcare providers, enabling them to maximize revenue while minimizing administrative burden and risk.

PayrHealth

Passed in 2020, the No Surprises Act has redefined out-of-network reimbursement. The law was created to protect patients from surprise medical bills for out-of-network care. However, payors can now push providers out-of-network and slash allowable amounts for care, effectively lowering reimbursement rates. Radix offers end-to-end claims arbitration through its IDR software on behalf of providers for fair reimbursement at scale.

The collaboration between PayrHealth and Radix aims to make the process between contract negotiations and claim reimbursement seamless. By combining PayrHealth's extensive expertise in payor contracting with Radix's groundbreaking IDR software, these companies give providers a critical tool to prevent underpayments, negotiate favorable in-network arrangements, and effectively manage the challenges of out-of-network reimbursements, setting a new standard for commercial reimbursement optimization.

Key client benefits of the partnership include:

  • Holistic Solution: A "one-stop-shop" approach that integrates contracting, credentialing, and reimbursement optimization, ensuring a streamlined experience for providers.
  • Ease and Efficiency: Providers can expect a simple, no-risk solution that requires minimal resources while delivering impactful financial results.
  • Transformative Impact: Addressing the critical challenges of out-of-network reimbursement with innovative, data-driven processes that provide significant financial outcomes.
  • "We're proud to offer our clients this new solution in partnership with Radix, which is an incredibly cost-effective way to create attractive and repeatable reimbursement without downside risk, an ideal complement to our contracting strategy," said Armando Cardoso, CEO, PayrHealth. "This collaboration aligns perfectly with our mission to empower providers by simplifying complex reimbursement and contracting processes, allowing them to focus on what they do best – patient care."

    "Radix solves the critical out-of-network challenges facing healthcare providers in today's evolving reimbursement landscape. Partnering with PayrHealth enables us to scale our impact and provide clients a holistic solution that truly transforms how providers approach their financial health," added Max Mangum, Co-founder and CEO, Radix. "Our next generation solution grows out-of-network revenue with repeatable, predictable results while ensuring a no-headache yet fully transparent partnership."

    About PayrHealth
    As the industry's leading Complete Payor Management solution, PayrHealth is a comprehensive partner to health care providers for services that include: payor contracting, credentialing, and revenue cycle management. PayrHealth empowers providers by simplifying payment processes and actively challenging the status quo when it comes to navigating complex payor landscapes. Led by experts who understand the universally-shared frustration that providers experience when negotiating contracts and managing reimbursement, PayrHealth focuses on providers' margins so they can focus on their mission. To learn more, visit www.payrhealth.com.

    About Radix
    Radix is the next-generation No Surprises Act IDR solution, helping providers boost commercial out-of-network reimbursement. Radix leverages cutting-edge data, software and client integrations to efficiently and seamlessly achieve optimal outcomes at scale. Designed as a commission-based and real-time transparent solution, Radix empowers providers to benefit from IDR with peace of mind. Embrace the modern payor strategy, pushing back against payors' underpayments and leveraging IDR as a tool for in-network negotiations. To learn more, visit www.radixhealth.io.

    Media contact
    media@payrhealth.com

    Radix

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    SOURCE PayrHealth