CONTRACTING & CREDENTIALING
Your MCO Middleman. Your Contract Negotiator. Your Inside Connection
From credentialing to contracts to fixing MCO issues, we’re your behind-the-scenes support team and your results partner. We negotiate stronger contracts, fix weak ones, and handle credentialing from start to finish — including carve-outs, out-of-network agreements, and escalations before they become problems.
Contracting & Credentialing
We help facilities secure new payer contracts, renegotiate underperforming agreements, and clean up MCO issues that block admissions and delay payment.
Beyond contracts, we handle credentialing and ongoing payer support — so your team has a real partner when eligibility, reimbursement, or authorizations get complicated.
What We Do
Secure new contracts with major MCOs
Renegotiate existing contracts (15–20% avg. rate increase)
Review underperforming deals — even if already signed
Obtain prior and out-of-network authorizations
Request carve-outs for high-cost drugs and therapy
Solve denials at the source
Clarify eligibility and reimbursement for hard-to-place cases
Act as your day-to-day resource for MCO questions
Improve Your Contracts and Coverage
Tell us what you’re trying to improve rates, coverage, credentialing, or an urgent payer issue and we’ll route you to the right specialist.
WHY CHOOSE CLAIMEX?
Advantages for Your Facility
Proven Relationship with National Payers
Live Support for Anyone on Your Team
Customized Contracting, No Templates
60% contract negotiation success
Immediate Action on All Escalations
What Makes Us Different
We treat every provider as unique — because they are. No boilerplate contracts. No hands-off support. We work your issue until it’s resolved, and we keep your team in the loop the entire time.