“I Take What I Get” — And Other Costly Myths About Your Payer Contracts Featuring Brett Spark, EP 267
Most private practice owners have a feeling that they're not being paid what they're owed by insurance payers — but very few can prove it. In this episode of The Thriving Practice Podcast, Tracy Cherpeski talks with Brett Spark of Aroris Health about why payer underpayment is so common, why almost no practice has its own contracts organized, and how visibility into the payer relationship can directly impact the profitability of a medical practice.
Brett's path is a unique one: he spent the first half of his career climbing the ladder inside a large regional health system before being recruited into a private practice CEO role. That shift exposed him to just how differently independent practices operate — with more autonomy, more speed, and far less red tape, but also far less infrastructure for managing complex payer relationships. Aroris Health grew out of that gap, evolving from a peer negotiation service into a software platform that digitizes contracts and tracks every claim against what a practice is contractually owed.
For practice owners thinking about time management for healthcare practice owners, running a profitable medical practice, or building private practice without burnout, this conversation reframes payer contract management from an overwhelming back-burner task into one of the highest-leverage things a practice owner can do.
Key Takeaways
Most practices don't have their own contracts organized. Brett notes that in six years of business, Aroris Health has yet to have a client who could produce all of their payer contracts, amendments, and fee schedules in one place.
Underpayment is rarely simple fraud — it's often complexity and drift. Rate changes, coding complexity, and contract amendments create frequent opportunities for errors to creep in undetected, sometimes for years.
Visibility, not just negotiation, is the real lever. Many practices assume their only option is to renegotiate rates, but Aroris Health often finds that practices are simply being paid incorrectly relative to their existing contract — a fixable error, not a negotiation.
Independent practices preserve choice in the healthcare ecosystem. Brett argues that empowering private practices to stay independent — rather than being absorbed by health systems or private equity — protects patient access to a different, often more personal, care model.
Doing something is better than doing nothing. Brett's parting advice: practice owners have a fiduciary responsibility to understand what they signed, whether they tackle it internally or bring in outside support.
Q&A
Why are independent practices losing money on payer contracts without realizing it?
According to Brett, most practices have never had full visibility into their own contracts — many can't even produce a complete copy of what they originally signed, let alone every amendment since. Without that visibility, it's nearly impossible to know whether a payer is reimbursing according to the terms that were actually agreed upon.
Is payer underpayment usually intentional?
Brett is careful not to assume bad intent across the board. He points to the sheer complexity of coding, modifiers, site-of-service rules, and contract terms that change year over year as a major driver of errors — alongside cases where payers simply aren't held accountable for catching their own mistakes.
How much revenue can be recovered once a practice gets visibility into its contracts?
Brett shares that Aroris Health has uncovered cases where a practice was paid the wrong rate for an entire year, resulting in six-figure and even million-dollar corrections — revenue that would have otherwise been permanently lost.
What's the first step a practice owner should take if they suspect they're being underpaid?
Brett's advice is to start by simply gathering the actual contracts, amendments, and fee schedules — something most practices have never done. From there, even a basic comparison between what's billed and what's paid can reveal discrepancies worth pursuing.
Episode Highlights
Brett's path from a large regional health system to private practice CEO — and what it taught him about autonomy and speed
Why Aroris Health evolved from a peer negotiation service into a payer-contract software platform
The six-year track record: no client has ever shown up with a complete, organized contract file
How the software digitizes contracts and flags discrepancies between contracted rates and actual claims paid
The Netflix subscription analogy: how reimbursement rates quietly shift without practices noticing
Why timely filing windows for correcting payer errors vary contract by contract
The case for preserving independent, private practice as a vital part of the healthcare ecosystem
Brett's parting advice: doing something is better than doing nothing
Memorable Quotes
“Don't buy into the narrative that has existed of, I just signed the contract, I take what I get.” — Brett Spark
“Visibility will lead to revenue opportunities.” — Brett Spark
“Doing something is better than doing nothing.” — Brett Spark
“I think to be successful, the practices that we're seeing really growing and evolving are taking a more focused approach: I need to essentially start right, to end right.” — Brett Spark
“Our mission is to preserve the spirit of medicine.” — Brett Spark
Brett Spark's conversation with Tracy is a reminder that the most overlooked opportunity in a private practice's finances might not be a new patient acquisition strategy or a pricing change — it might be the contract that's already been signed and never fully read. For practice owners who've ever had the nagging feeling that they're not being paid what they're owed, this episode offers a concrete, fiduciary-minded path forward: get visibility first, then decide what to do with it. Share this episode with a colleague who manages the business side of their practice and visit ArorisHealth.com to learn more about Brett's work. Explore ThrivingPracticeCommunity for additional resources to help you build a practice that truly thrives.
Guest Bio:
Brett Spark has spent his career inside the business of healthcare — first climbing the ranks of a large regional health system, then taking the leap into private practice as a CEO. That shift changed everything. Seeing firsthand how payer contracts shape both financial performance and patient care, Brett co-founded Aroris Health to give independent practices the clarity and tools they need to navigate those relationships with confidence. Today, Aroris combines negotiation expertise with a purpose-built software platform that helps practices understand exactly what they're owed — and actually get it.
Find Brett:
Website: ArorisHealth.com
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