Partner solutions · Billing and RCM
Extend your payer-operations capabilities with a dedicated operating layer.
Ellery Health Partners provides a managed payer-operations layer for billing companies and RCM organizations serving independent medical practices. Add defined payer-facing workflows to your client offering through a partner model with documented scope, capacity, responsibilities, and delivery.
A defined operating layer for payer work.
Ellery Health Partners works inside the practice’s approved systems to manage defined payer-facing administrative workflows. Depending on scope, that can include 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.
The model gives billing and RCM organizations additional payer-operations capacity through defined workflows, documented responsibilities, and established clinical escalation pathways. Partner engagements establish clear ownership of payer workflows so Ellery and the billing or RCM partner can operate within defined responsibilities. Ellery may support workflows such as authorization, payer follow-up, denial and appeal administration, eligibility and benefits, credentialing, enrollment, and other approved payer-facing functions defined in the engagement.
Engagements can be white-label or referral-based, with scope, capacity, commercial terms, access requirements, and responsibilities documented before activation.
Two ways to work with Ellery Health Partners.
White-Label Desk
Extend your own service model with Ellery Health Partners operating behind your brand for the payer-operations workflows included in the engagement.
- Client-facing communication can carry your brand.
- You retain the client relationship.
- You set your price to the practice.
- Ellery Health Partners manages the contracted payer-operations workflow.
- Named access remains visible where required for security, audit, or compliance.
- Partner pricing, scope, responsibilities, and branding expectations are documented in writing.
Referral Relationship
Refer practices directly to Ellery Health Partners when payer-operations needs fall outside your current service model.
- Ellery Health Partners handles scoping, onboarding, service delivery, and ongoing support.
- Ellery Health Partners owns the direct service relationship for the referred scope.
- Referral terms, if used, are documented separately from the practice agreement.
- No PHI is requested during partnership evaluation or scoping.
Your revenue cycle relationship stays yours.
Ellery Health Partners works alongside billing and RCM partners by providing defined payer-operations capacity for the administrative workflows assigned to Ellery.
Our role is limited to the payer-operations services defined in the partner arrangement.
Payer-operations capabilities.
Prior Authorization
Medical-benefit authorization workflow from requirement determination and submission through payer follow-up and determination documentation.
Medication Access & Pharmacy Benefits
Pharmacy-benefit and specialty-drug prior authorization, exceptions, benefits investigation, and hub and assistance-program enrollment.
Eligibility, Benefits & Financial Clearance
Coverage and service-level benefit verification, patient-responsibility estimates, and pre-service financial-clearance status.
Referral Management
Referral requirement determination, referral tracking and renewal, and coordination with authorization and scheduling.
Claims & A/R Administration
Payer-facing claim status research, aging A/R follow-up, missing-information resolution, underpayment and recoupment follow-up, and payer escalation.
Denials & Appeals
Denial research and categorization, appeal packet assembly, submission, deadline tracking, payer follow-up, and denial trend reporting.
Credentialing & Payer Enrollment
Credentialing administration, CAQH, payer enrollment, revalidation, roster maintenance, and application follow-up.
Payer Contracting & Network Administration
Participation requests, contract administration, fee-schedule review, and negotiation support, custom scoped.
Commercial model
Partner capacity and pricing are established after review of the services required, expected volume, payer mix, workflow complexity, follow-up requirements, and engagement structure.
Partner pricing is documented in a written partner schedule before work begins.
Next step
Discuss a partner arrangement.
Send us your company name, the practices and specialties you support, the payer-operations workflows you want to extend, approximate volume, and your preferred relationship model. We will respond with a proposed partner scope and next steps.