Case Study: PathNet breaks through payor barriers with PayrHealth

PathNet secures 100% of CMS for commercial claims with PayrHealth

PathNet, a specialized digital pathology laboratory, faced significant challenges securing in-network contracts with major payors, particularly a large national payor that had closed its lab network. This barrier threatened their growth and revenue. They engaged PayrHealth as a strategic partner to navigate the complex credentialing processes and overturn these denials.

PayrHealth developed a persistent strategy, leveraging deep market relationships to tell PathNet's unique story and appeal initial denials. This effort successfully overturned a major denial in a closed Utah market. The results were exceptional, with PathNet securing nearly 50 contracts and achieving elevated reimbursement rates of 100% of CMS for commercial claims and 90% for Medicare, far surpassing the industry standard. PayrHealth's solution provided critical market access and directly secured highly competitive revenue for the lab.

PathNet