SOLVING COMPLEX REVENUE CYCLE PROBLEMS IN HEALTHCARE THROUGH DATA TRANSPARENCY

Our Services

Price Transparency Payor Negotiations

With market reimbursement data for 503 payor networks across the United States, we empower providers and their payor contracting teams with invaluable resources to benchmark rates to competitors, evaluate pricing strategies, and find new opportunities.

Our done-for-you payor negotiations leverage our breakthrough strategy with unprecedented results - averaging a 12% increase across major payors (BCBS, United, Cigna, Aetna).



Price Transparency Payor Negotiation Services Include:

  • On-demand market reimbursement data and dashboards

  • Reimbursement and competitor benchmarking and statistical analysis and reporting

  • Performance-based payor negotiations

  • Complex contracting analysis - carve-outs, multi-state/location/specialty, entering new markets, etc.

Revenue Cycle Management

Traditional Revenue Cycle Management services have historically operated at 70%+ margins, take a percentage of cash collections, and rarely fulfill their value-accretive promises—Opilio’s RCM model is different.

Opilio’s model is based on transparent pricing, and when bundled with our Price Transparency Payor Negotiations, we are so confident that our services will increase your revenue that we offer a performance-based guarantee.

*Ask about our complimentary coding audits and 15-day free trial.

Revenue Cycle Management Services Include:

  • Medical coding

  • Medical billing

  • AR analysis and denial management including follow-up & claims resubmission

  • RCM reporting and data analytics

  • Other - provider credentialing, forensic medical coding audits, claims analysis, etc.

Strategic Finance & Custom Solutions

Opilio’s team, led by a seasoned CPA with a background in healthcare forensic accounting and mergers and acquisitions, understands the current economic conditions of the industry.

Large healthcare organizations have Chief Revenue Officers, large billing and RCM teams, and payor contracting and negotiation teams that manage these strategic and operational functions to maintain margins and profitability.

Today, Opilio gives smaller medical practices the opportunity to enjoy these same benefits.

Strategic Finance & Custom Solutions Include:

  • Fractional CRO services

  • Transaction Advisory / Distressed Situations / Turnaround & Restructuring

  • Custom analytics and integrated practice management dashboard applications

  • Healthcare-related disputes, litigation support, financial forensics, and expert witness

  • Accounts Receivable Factoring (only in Texas)

  • Strategic Debt & Equity Financing

Why Opilio

Extensive Experience

Over thirty years of combined healthcare-specific industry experience and millions of dollars in ROI for our past clients. Our experiences range from overseeing over 80 healthcare M&A transactions, healthcare forensic accounting, valuation, litigation support, operational strategy consulting, and HIPAA-compliant digital transformation.

Powerful Results

In a short time, Opilio has already added over $500,000 in incremental revenues to our clients through our data-driven payor negotiations.

Currently averaging 12% increases to major payor reimbursement rates, Opilio understands that outcomes matter most to our clients. We take our commitment to excellence seriously, bet on ourselves, and offer performance-based fee structures.

Performance Based

We know the healthcare industry has been ripe with service companies creating high-margin businesses, while the margins of the healthcare organizations have consistently been eroded.

Opilio’s core services are performance-based and our transparent pricing model ensures that our work generates real, measurable value to your bottom line.

What Our Clients Are Saying

  • "Opilio played a pivotal role in helping us remain financially sound, providing us with insightful knowledge and deeper relationships with our payor networks.”

    Dr. Christopher Taylor, CEO - Taylor Counseling Group

  • "We found Opilio's business model to be a novel concept that achieved an 11.3% increase for a major payor."

    Eric Brandt, CFO - Pearl Street Dental Partners

  • "Opilio's work was transparent, timely, and eye-opening as to what is possible when price transparency data, smart strategy, and integrity are combined in a collaborative process."

    David Buck, CFO - Taylor Counseling Group

  • "We chose Opilio because of the integrity in which they do business."

    Kim Foret, CFO - Reliant Specialty Infusion

  • "Opilio's attention to detail and ability to analyze vast amounts of data quickly is a great benefit to us."

    Bob Gray, Managing Member - Gray, Schrupp, & Associates

2024 Outstanding Leadership in Healthcare Award Recipient

Founder, Sean Shahkarami, accepts the 2024 Outstanding Leadership in Healthcare award on behalf of Opilio at the Health2.0 Conference and gave the keynote address.

Faith-Based & Mission-Driven

Sean K. Shahkarami, CPA, CFF, MAc - Founder & CEO

“At our core, Opilio is and will always remain, a faith-based and mission-driven organization that prioritizes positive impact over profits.

Our main goal is to lower the cost of healthcare without changing the reimbursement incentive model.

I do not claim to have all the answers, but I have faith that strategic problem solvers equipped with state-of-the-art technology will come up with them.”

 Let’s work together.

 

We are located in the 4th floor at 5049 Edwards Ranch Rd. Clearfork, Fort Worth, TX 76109

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