A disciplined operating model for payer operations.
Ellery Health Partners is a healthcare payer-operations company for independent medical practices and healthcare organizations. Our operating model is built around clearly assigned workflows, documented activity, defined service boundaries, and accountable delivery.
We manage the administrative relationship between practices and payers, from patient access and treatment authorization through reimbursement, appeals, provider enrollment, and payer participation. Depending on the engagement, that includes eligibility, benefits and financial clearance, referral management, prior authorization, medication access and pharmacy benefits, claims and A/R administration, denials and appeals, credentialing and payer enrollment, and payer contracting and network administration.
Work is performed through practice-approved systems and authorized payer channels. Each engagement establishes the services included in scope, expected capacity, documentation requirements, escalation points, and responsibilities retained by the practice.
This structure allows an organization to assign payer-facing administrative functions to Ellery Health Partners while maintaining visibility into activity, control over system access, and appropriate clinical oversight.
Operating principles
Clear ownership
Administrative responsibility is established within the service scope, including execution, follow-up, documentation, and escalation.
Documented activity
Payer calls, submissions, requirements, reference numbers, status updates, and follow-up activity are documented within the approved workflow.
Defined scope
Each engagement establishes the services Ellery Health Partners performs, the responsibilities retained by the practice, the systems used for delivery, and the circumstances requiring escalation.
Clinical and practice responsibilities
Ellery Health Partners provides managed payer-operations capacity for specialty practices and healthcare organizations. We manage defined payer-facing workflows across patient access, authorization, reimbursement follow-up, denial resolution, provider enrollment, and network administration.
Each engagement establishes the workflows, capacity, responsibilities, and escalation pathways assigned to Ellery.
The treating practice and its licensed clinicians retain responsibility for clinical decisions, medical-necessity determinations, medical advice, diagnosis and procedure code selection or modification, physician peer-to-peer reviews, provider signatures and attestations, and all representation as the treating provider.
Discuss your requirements
Provide your practice information, the services under consideration, and approximate monthly volume. Ellery Health Partners will review the requirements and respond with the appropriate service scope and next steps.
No patient information is requested or accepted through this website.