Services
Specialized Consulting for Complex Challenges
Our insights have helped clients recover missed revenue and realize returns of up to 10X on independent dispute resolution and informed managed care negotiations.
Financial performance and payor relationships are more complex than ever and high-stakes miscalculations can cost providers millions. McClure Health Solutions delivers clarity and value where others can’t, with services built on decades of insider experience and a sharp focus on revenue recovery.
Independent Dispute Resolution
We secure competitive out-of-network reimbursement through federal and state-level dispute processes. With a deep understanding of the federal No Surprises Act (NSA) and expert knowledge of the Texas Department of Insurance (TDI) regulations, we efficiently and effectively support every phase of resolution.
Out-of-Network Independent Dispute Resolution (IDR)
Strategic guidance and hands-on support for submissions, winning documentation, settlements, and contracting.
No Surprises Act IDR Arbitration
Clarity and compliance with informal and formal federal processes, helping you encourage settlement and prevail in arbitration.
Texas TDI IDR Mediation
State-specific expertise that ensures streamlined processes and financial outcomes.
Competitive Market Assessment
Our market analysis combines price transparency data with industry experience to establish a clear managed care strategy and negotiate from a place of strength.
Data-Driven Market Insights
We analyze network composition, reimbursement patterns, and competitor rates using publicly available and proprietary data.
Benchmarking for Favorable Contracts
Identify where your rates underperform—and where you can pursue better pricing.
Customized Reporting
Each analysis includes tailored recommendations to improve payor contracts and market positioning.
Managed Care Strategy
We work alongside your team to strengthen your managed care portfolio, enhancing contract performance, payor relationships, and long-term network value.
Contract Performance Evaluation
Identify what’s working and what’s not in your existing agreements.
Negotiation Support
Build stronger payor relationships across Commercial, ACA, Medicare Advantage, and Medicaid products.
Strategic Planning for Growth
Define your managed care approach to recover revenue and fuel long-term growth.
A Partner You Can Trust
Let’s discuss how you can chart a direct course to improve financial performance with McClure Health Solutions.