Proprietary claim analytics
Identify pre-payment and post-payment opportunities on behavioral health claims—surfacing recoverable dollars generic billing vendors write off.
Revenue recovery
Negotiation that recovers what you're owed
Cipher pursues every dollar your contracts entitle you to—through proprietary pre-payment and post-payment claim negotiation, underpayment identification, and payer contract negotiation support tied to your behavioral health claims data.
- Proprietary pre- and post-payment claim negotiation
- Underpayment identification from EOB/ERA analysis
- Payer contract negotiation support
- 100% pre-payment review success
- Partners see up to 70% reimbursement increases through negotiation tactics
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Why Cipher
Negotiate claims and contracts from your billing data
Cipher does not stop at claim submission. Our proprietary analytics identify pre-payment and post-payment opportunities to challenge underpaid or finalized claims—sometimes recovering up to 70% additional reimbursement, as we outline on our FAQ and onboarding materials.
During onboarding we audit accounts receivable, payments, and payer contracts alongside compliance and utilization review—so negotiation strategy reflects how your programs actually bill residential, PHP, IOP, detox, and outpatient services.
What's included
How Cipher delivers
Pre- & post-payment negotiation
Aggressive claim negotiation before and after payment—aligned to Cipher's Phase two onboarding model, not passive A/R reporting.
Payer contract negotiation support
Support for leadership renegotiating payer terms—with claims data, denial trends, and reimbursement patterns from your census, not generic industry averages.
Underpayment identification
EOB and ERA analysis flags allowed-amount gaps, contract mismatches, and systematic underpayments before they compound in A/R.
Rate & reimbursement monitoring
Track how contracted and out-of-network rates perform against expectations—Cipher averages 30.36% OON reimbursement with partners seeing higher returns through advanced negotiation tactics.
Appeals & resubmission
When negotiation requires clinical documentation, Cipher ties appeals and systematic resubmission to the same workflow—97% medical appeal success rate on our RCM benchmarks.
Process
How it works
- 01
Onboarding audit
Comprehensive reviews of compliance, utilization review, accounts receivable, payments, and payer contracts—establishing a baseline before claims scale.
- 02
Identify recoverable dollars
Proprietary analytics flag underpayments, contract edit patterns, and finalized claims worth challenging—prioritized by payer and level of care.
- 03
Negotiate & escalate
Pre-payment and post-payment negotiation on claims, with payer contract negotiation support when leadership pursues stronger terms.
- 04
Validate collections
Confirm recovered amounts post to clean ledgers—variance reporting and A/R follow-up until negotiated dollars are collected or avenues are exhausted.
Practices
Specialty billing by level of care
Services
Platform capabilities
FAQ
Contract Negotiations questions
What does Cipher mean by contract negotiations?
Cipher combines payer contract negotiation support with proprietary pre-payment and post-payment claim negotiation. We challenge underpaid and finalized claims using analytics built for behavioral health—while helping leadership enter payer conversations with evidence from your actual reimbursement data.
Does Cipher negotiate payer contracts directly?
Cipher prepares data-driven negotiation materials and supports your leadership through payer contract negotiation. Final contract authority remains with your organization—we ensure you have behavioral health–specific claims evidence, not generic benchmarks.
What is proprietary post-payment negotiation?
After a claim is paid, Cipher's analytics can identify opportunities to challenge finalized claims for additional reimbursement. Our FAQ notes partners sometimes see up to 70% more through this post-negotiation process when documentation and payer rules support it.
How does this connect to denial management?
Denials, underpayments, and contract edits share root causes. Cipher pursues appeals, resubmission, and negotiation in one revenue cycle workflow—with 24-hour denial response on our RCM service benchmarks.
Who is my main point of contact at Cipher?
Every client receives a dedicated Partner Experience Executive—a named advocate for billing questions, reporting, and escalation—not a generic call-center queue.
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“We needed a billing company that conducted business similarly to how we do, prompt and intentional. Cipher has exceeded our expectations. They've continued to be easily accessible & helpful with all our billing needs!”
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