The Hidden Cost of Not Knowing Your Worth
Most providers assume their payer rates are reasonable enough to keep the practice running, even if they suspect they could be better. Between seeing patients, managing staff, staying on top of accounting & bookkeeping, and making sure claims eventually get paid, there's rarely time to dig into whether those rates are actually competitive, and even less access to the kind of data that would answer the question definitively.
The result is that many providers are getting systematically underpaid without realizing it, and by the time the pattern becomes clear, they've already left significant revenue on the table.
The Built-In Asymmetry of Healthcare Negotiations
When you think about it, the deck has always been stacked this way. Large healthcare organizations employ entire teams whose job is to benchmark every contract, analyze reimbursement trends, and squeeze out better rates during negotiations. Meanwhile, independent practices are trying to keep the lights on and patients happy, which leaves almost no bandwidth for the kind of deep financial analysis that drives better payer contracts. The asymmetry is built into the system.
We built Flychain's Contracted Rate Analysis tool because we think smaller providers deserve the same negotiating leverage as the big hospital systems. The tool takes your contracted rates and compares them against what similar providers in your region and specialty are actually getting paid, using real market data rather than national averages or outdated benchmarks.
Where Underpayment Actually Hides
What typically emerges is a pattern where certain high-volume procedures are being reimbursed well below market rates, creating revenue gaps that compound over time. This isn't usually a case of systematic underpayment across the board, but rather specific procedures where rates have fallen behind market standards, likely because those particular line items haven't been renegotiated in years.
Real Impact: A Pediatric Practice's Discovery
One pediatric practice we work with had been operating for years under the assumption that their rates were standard for their area. They had no particular reason to think otherwise, and their claims were being processed and paid without any unusual delays or denials. When we ran their data through our contracted rate analysis tool, we discovered that several of their most common procedures were being reimbursed at rates in the bottom 25th percentile compared to other pediatric practices in their region.
This wasn't immediately obvious from their day-to-day operations. Claims were paid on time, the practice was profitable, and there were no red flags in their revenue cycle. But those below-market rates on high-volume procedures were quietly costing them thousands of dollars every month.
Armed with this information, they scheduled a meeting with their payer representative and presented the benchmarking data. The conversation was straightforward and professional, focusing on the market data rather than ultimatums or threats. Within a few weeks, they had successfully renegotiated the rates for those specific procedures, bringing them up to market standards. The entire process was remarkably smooth once they had the right information to support their case.
The Compound Effect of Small Discrepancies
What we've learned from helping dozens of practices through this process is that underpayment rarely happens uniformly. More often, you'll find a handful of procedures where rates have drifted below market over time, usually because they're buried in legacy contracts or overlooked during routine renegotiations. These might seem like small discrepancies on paper. Maybe you're getting $85 for a procedure that should pay $95, but when you multiply that $10 difference by hundreds of visits per year, over multiple procedures, across several years, the numbers become staggering.
Leveling the Playing Field
Until recently, this kind of detailed rate benchmarking was only available to large healthcare organizations with the resources to commission expensive consulting studies or maintain dedicated analytics teams. Independent practices were left to negotiate based on gut feeling and whatever limited information they could gather from informal networks. We believe every provider should have access to the same insights that help them understand their true market position and negotiate from a place of knowledge rather than guesswork.
The goal here is simple: to give independent practices the tools to operate like sophisticated businesses without having to become financial analysts themselves. Our platform integrates contracted rate analysis directly into your financial workflow, making it easy to spot opportunities and track improvements over time.
Beyond Individual Negotiations
The impact goes beyond individual practice negotiations. When more providers have access to transparent rate data, it creates upward pressure on reimbursements across the market. Payers can no longer rely on information asymmetry to maintain below-market rates. This benefits not just the practices using our tools, but the entire healthcare ecosystem in a region.
Conclusion: Knowledge is Negotiating Power
Knowing whether you're being paid fairly shouldn't require a team of consultants or a degree in healthcare economics. Sometimes all it takes is seeing your rates in context to realize it's time for a different conversation with your payers. The practices that are thriving in today's healthcare environment aren't necessarily the ones seeing the most patients, they're the ones who understand their worth and have the data to prove it.
Ready to discover if you're leaving money on the table? Schedule a demo of Flychain's Contracted Rate Analysis Tool and see exactly where your rates stand in your market. Because every dollar you're underpaid is a dollar that could be invested in better care, better staff, or better growth.