Benchmarking and Rate Validation. Is the Contract Worth it?

Aegis gives investors a defensible view of revenue quality, contract strength, and regulatory risk—before capital moves. We validate what’s in the deck, quantify what isn’t, and map the truth behind the revenue so you buy with confidence (or walk away fast).

Contracts drive the model—if the rates don’t realize, the thesis doesn’t either. We benchmark the target’s contracts against market comps and analyze rate realization by payer and service line to size true upside (and downside). You get a defensible view of what’s collectible, where renegotiation is viable, and how fast value can be unlocked post-close.

What To Expect:

  • Benchmarking: Fee schedules by CPT/HCPCS, region, site of care; escalators, carve-outs, and parity vs. peers.
  • Rate Realization: Contracted vs. allowed vs. paid; denial/underpayment drag; mix and setting impacts.
  • Term Risk: Timely filing, audit/appeal windows, prepay review/PA clauses, retro takebacks, termination provisions.
  • Payer Posture: Dispute history, overturn rates, OON exposure, concentration risk, network strength.
  • Upside Levers: Targeted payers/codes for uplift, carve-out opportunities, site-of-care shifts, and bundling risks.

Our Deliverables

  • Benchmark Report with payer/service-line gaps and prioritized targets.
  • Rate Realization Model (contracted → allowed → paid) with sensitivity scenarios.
  • Renegotiation Playbook: sequencing, talking points, and expected yield by lever.

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