For outpatient practices
Give payer work somewhere to go.
Your staff should not have to carry every payer problem internally.
Prior authorizations, benefit verification, payer follow-up, claims issues, denials, appeals, credentialing, and enrollment all compete for the same finite administrative capacity inside a practice.
Ellery Health Partners gives defined payer workflows a dedicated place to go.
Independent specialty practices often have payer work distributed across multiple capable teams. The resulting challenge is one of ownership and capacity.
Payer work lands on:
- Front-office staff
- Clinical staff
- Authorization teams
- Billers
- Managers
- Providers
The same case may move between several people because no single operating function owns the entire payer-facing workflow.
Ellery creates defined operational ownership.
We work inside practice-authorized systems, follow documented responsibilities and escalation pathways, and return clinical decisions to the practice when clinical judgment is required.
Ellery Health Partners may be a fit for practices with:
- Recurring payer-operations workload
- Eligibility, benefits, and financial-clearance volume
- Referral and prior authorization volume
- Specialty medication and pharmacy-benefit access requirements
- Claims requiring payer follow-up and aging accounts receivable
- Denial and appeal workload
- Credentialing, enrollment, licensing, and payer-contracting activity
- Internal capacity constraints and a need for defined external workflow ownership
Protect staff capacity. Keep control of your practice.
Ellery operates alongside your existing clinical, administrative, billing, EHR, and practice-management infrastructure as the accountable administrative layer for the payer workflows assigned to us.
Your practice maintains control of its systems, patient relationships, clinical decisions, and internal operations. Ellery manages the payer-operations scope defined in the engagement.
Where Ellery fits
Before treatment
Eligibility, benefits, referrals, authorizations, and medication-access requirements.
Before reimbursement
Authorization status, coverage issues, documentation requirements, and payer-related administrative readiness.
After billing
Claim-status follow-up, aging A/R activity, underpayments, payer correspondence, and recoupment issues.
After denial
Denial research, reconsideration, appeal administration, deadline tracking, payer follow-up, and root-cause visibility.
When providers join or change
Credentialing, payer enrollment, revalidation, licensing, privileging, and network administration.
Support across independent medical specialties.
Ellery Health Partners supports defined payer-operations workflows across a range of independent medical specialties. The service mix depends on practice requirements, payer environment, volume, systems, and workflow complexity.
Payer operations by specialty:
- Orthopedics, Spine, and Pain Management
- Dermatology
- Oncology and Infusion Practices
- Rheumatology
- Gastroenterology
- Neurology
- Ambulatory Surgery Centers
- Endocrinology
- Ophthalmology and Retina
- Cardiology and Imaging
- Allergy and Immunology
- Behavioral Health & ABA Organizations
Ellery Health Partners supports medical-benefit and pharmacy-benefit workflows. The payers, programs, and workflows included in an engagement are defined in the written scope.
Billing and RCM companies can work with Ellery Health Partners through white-label or referral arrangements. See For billing companies.
How Ellery Health Partners enters your workflow
Practice review
Tell us about your specialty, approximate monthly volume, payer environment, and the type of support you need.
No patient information is requested or accepted through the public website.
Written scope and pricing
Ellery Health Partners reviews the requested workflow and provides a written proposal identifying the services, responsibilities, case capacity, pricing, and onboarding requirements.
Agreement and access
Before live work begins, the Business Associate Agreement is completed and the applicable security, training, device, and access requirements are established.
The practice provisions and controls the accounts and permissions used by Ellery Health Partners.
Administrative casework
Ellery Health Partners performs the contracted payer-operations work inside the practice’s authorized systems and documents actions, payer reference numbers, requirements, statuses, and outcomes.
Clinical escalation
Questions requiring clinical judgment, medical-necessity decisions, coding decisions, provider attestations, or peer-to-peer review are returned to the appropriate practice representative.
Clear responsibilities within every engagement
Ellery Health Partners responsibilities are defined by service scope so the practice, Ellery Health Partners, and any partner organization understand where administrative ownership begins and ends.
Ellery Health Partners handles
Within the contracted scope, Ellery Health Partners can:
- Perform the payer-operations workflows defined in the applicable Service Order
- Work through practice-approved payer portals, systems, and authorized telephone channels
- Prepare and organize administrative documentation available within the approved workflow
- Identify missing information for the practice to provide
- Submit administrative requests and materials where applicable to the contracted service
- Monitor status and perform payer follow-up within scope
- Coordinate routine payer requests using information available within the authorized workflow
- Record actions, payer reference numbers, requirements, statuses, and outcomes
- Escalate matters requiring clinical judgment, coding decisions, provider signatures, or responsibilities retained by the practice
Your practice retains
The practice and its licensed clinicians retain responsibility for:
- Clinical decisions
- Medical-necessity determinations
- Diagnosis and procedure code selection or modification
- Clinical answers to payer questions
- Peer-to-peer clinical reviews
- Provider signatures and attestations
- Treatment decisions
- Final review and signature of any written appeal
Formal appeals, credentialing and enrollment, medication access, referral management, payer contracting, and work outside the contracted scope require separate approval and pricing.
A defined operating approach
Every Ellery Health Partners engagement is structured around:
- Experienced U.S.-based Healthcare Administration Professionals: Contracted work is performed by personnel located in the United States.
- Ellery’s team: Each engagement is supported by Ellery’s U.S.-based team, trained for the payer-operations workflows included in the contracted scope. Work is performed through the practice-approved systems and payer channels required for that engagement after onboarding and access are complete.
- Practice-controlled access: The practice provisions, controls, and can revoke system access.
- Written service scope: Responsibilities, capacity, pricing, and exclusions are documented before service begins.
- Documented activity: Work is recorded in the practice’s authorized system.
- Administrative boundaries: Clinical and coding responsibilities remain with the practice.
- Approved additional work: Services outside the agreed scope require practice approval before they are performed.
Ellery Health Partners does not guarantee payer approval or payer response time.
Begin with a clear practice review
Tell us about the payer work your practice is handling now and the support your practice needs. We will review the information and provide the appropriate service recommendation, scope, and next steps.
Ellery Health Partners does not request or accept patient information through this website.