Our Allergy & Immunology Advisory Solutions
Advisory organized around the economics you manage
Not a service menu — the reimbursement problems that decide allergy and immunology margin and enterprise value, and the strategy, analytics, and negotiation capabilities that resolve them.
01
The Challenge — You can't negotiate what you haven't benchmarked
Contract Assessment & Reimbursement Benchmarking
We digitize and normalize every payer contract and fee schedule, then benchmark your allergy and immunology reimbursement — E/M, testing, immunotherapy, and drug administration — against Medicare and against market, including buy-and-bill margin over ASP. We quantify exactly where you sit and what the opportunity is worth.
Contract digitization
Fee schedule normalization
% of Medicare benchmarking
Immunotherapy & testing rate analysis
Buy-and-bill margin over ASP
EOB & payment variance analysis
Under- & overpayment identification
Revenue opportunity quantification
Contract performance scoring
02
The Challenge — Little leverage one contract at a time
Managed Care Negotiations & Strategy
We build the positioning, data, and negotiation strategy to improve commercial rates, protect in-office drug administration, and resist white-bagging and specialty-pharmacy mandates across every payer — from renewals to executive payer meetings.
Commercial rate improvement
Buy-and-bill & site-of-care defense
White-bagging pushback
Contract renewals & redlining
Escalation & executive strategy
Network participation strategy
03
The Challenge — Decisions made without modeling the drug channel
Contract Modeling & Analytics
CPT-, HCPCS-, and payer-level modeling that turns claims, drug-purchasing, and contracts into scenario analysis, buy-and-bill margin forecasts, and side-by-side contract comparisons your executives can act on.
CPT & HCPCS reimbursement modeling
Buy-and-bill margin scenarios
Payer mix & revenue forecasting
Immunotherapy volume modeling
Site-of-care impact modeling
Executive Power BI dashboards
04
The Challenge — Negotiating blind to what competitors are paid
Payer Transparency & Market Rate Intelligence
Federal Transparency in Coverage data has transformed the negotiating table. We mine machine-readable rate files to show what competing allergy groups are actually paid on visits, testing, and administered drugs — and arm your team with it.
Transparency in Coverage analysis
Competitor rate benchmarking
Drug & administration rate mining
Negotiation preparation
Peer comparison
Commercial opportunity sizing
05
The Challenge — Effort spread evenly across unequal payers
Covered Lives & Market Intelligence
We map covered lives, payer penetration, referral dynamics, and ENT-allergy competitive presence across your market so you prioritize the negotiations and drug-channel decisions that move the most margin.
Covered-lives analysis
Payer penetration & market share
Referral & catchment dynamics
ENT-allergy competitive mapping
Employer & population trends
Commercial opportunity identification
06
The Challenge — Contract terms that aren't honored
Payer / Provider Disputes & Enforcement
When payers deny biologic starts, force white-bagging, downcode immunotherapy, or delay drug payment, we lead the interpretation, escalation, and enforcement — turning contractual entitlement into collected revenue.
Contract interpretation
Drug & claims payment disputes
Step-therapy & prior-auth challenges
Escalation support
Executive negotiation
Contract enforcement
07
The Challenge — Earned revenue that never arrives — on both sides
Underpayment / Overpayment Recovery & Revenue Integrity
Our analytics compare contracts, ASP schedules, allowables, and EOB/remittance data to detect variances on high-cost drugs and immunotherapy, quantify recoverable revenue, manage overpayment exposure, and fix the root cause so leakage stops.
Contract compliance auditing
Under- & overpayment detection
ASP & drug-payment variance analytics
Recovery & appeals strategy
Root-cause remediation
Revenue integrity programs
