Own your payer contracts. If your vendor owns them, you don't have insurance revenue. You have a lease.
How do I own my payer contracts instead of renting a network?
To own your payer contracts, form your own professional corporation with a physician owner, then file payer contract applications in that PC's name. Anvil runs this in parallel while you bill on our credentialed PC, then moves each payer's volume to your entity as its contract becomes effective. The contracts stay with your PC if you switch vendors.
Updated November 1, 2026
Own your payer contracts instead of staying on network rental. Forward this to your board: what network rental vs owning contracts actually means, why rental is the right way to launch, and why it is the wrong place to stay.
What does it mean to own your payer contracts?
The participation agreements sit in an entity you control, with portable payer contracts and billing under your own entity.
Rent a PC vs own a PC
Do both, in order. Renting a PC gets you billing in weeks because the payer contracts already exist. Building your own PC is how you end up owning the contracts, but new commercial contracts commonly take 4 to 8 months. Anvil launches you on our PC and forms yours in parallel, so building never delays revenue.
The entity is an MSO-PC structure for telehealth. Already on a vendor? Start with switching from a network rental vendor. Filing applications in that entity's name is payer contracting for telehealth. Going from cash pay to those contracts is laid out in the cash-pay to insurance two-phase plan. The papering follows corporate practice of medicine for telehealth.
Published ranges for the codes you would contract are on 90837 reimbursement rates by state.
What is network rental in telehealth, and what are the risks?
Network rental means you bill insurance under a vendor's professional corporation and its payer contracts. It is a fast way to launch. The risk is that you never hold the contracts: the vendor can end your network access, and investors will ask whether your insured revenue runs through an entity you control. Anvil rents to launch, then migrates you.
This is different from a health plan leasing a PPO network, which is also called network rental. A care company being in-network with payers is a different idea, covered in what in-network nationally means.
Network rental is renting your revenue
You never hold the contract
The payer contracts, rates, and relationships sit in the vendor's entity. If you leave, you start from zero. Your entire insured revenue runs through a company you do not control.
You never see the rate
You are paid a lease fee, not the contracted rate. You cannot negotiate with a payer. You cannot see the ladder. You cannot tell whether the fee is fair.
One vendor, one point of failure
A payer terminating the vendor's group contract terminates every customer's coverage with that payer at once. That is concentration risk your investors will ask about.
Renting is still the fastest way to launch. The mistake is treating it as the destination. Read whether to rent a PC or build your own professional corporation, how an MSO-PC structure for telehealth is papered, and how corporate practice of medicine for telehealth applies to your own PC. If you are already on a vendor, start with switching from a network rental vendor. Compare that path on the Bridge alternative fact table.
How to own your payer contracts
- Launch on our PC so clinicians are billing while your entity is formed.
- Form your PC and place a physician owner.
- Contract and credential that PC. File applications in your PC's name.
- Move volume as each contract goes effective. Claims in flight are unaffected.
How volume moves from our PC to yours
Both tracks start on day one. Nothing about the migration gates your launch or interrupts billing.
As volume moves, claims follow the entity through telehealth revenue cycle management, and Medicaid MCO panels move the same way under behavioral health payer contracting.
Your PC is formed in launch states. Physician owner matched. Clinicians roster-added under Anvil's contracts. You are billing.
Credentialing files built under your entity. Contract applications filed in your PC's name with your top payers.
First commercial contracts effective. New visits with those payers route to your PC. Claims in flight are unaffected.
Medicaid MCO and remaining commercial contracts land. Majority of volume on your own contracts. Platform fee steps down.
Steady state. Anvil runs RCM and renewals on contracts you own. Rental PC stays available for new states and closed panels.
Drag through the first 18 months
A typical migration. Volume moves to your PC as each payer contract in your name becomes effective. The platform fee steps down with it.
Portable payer contracts: an asset, not a dependency
- Your own professional corporation in every state you operate
- A licensed physician owner under a friendly-PC structure
- Executed MSO and PC agreements, structured for each state's CPOM rules. See MSO-PC and corporate practice of medicine.
- Payer contracts in your entity's name, with portable payer contracts and billing under your own entity
- Credentialing files for every clinician, portable
- Reporting by payer, state, clinician, and code, under your entity
What investors ask, and what the answer should be
| Question | On rental forever | After migration |
|---|---|---|
| Does insured revenue run through an entity you control? | No | Yes |
| Are payer contracts assignable in a sale? | There are none to assign | Yes, they are the company's |
| Can a single vendor terminate network access? | Yes | No |
| Do you know your contracted rates? | No, lease fee only | Yes, by payer and code |
| What is the switching cost? | A relaunch | A vendor change |
Payer contract diligence checklist
The twelve questions we would ask any care company about its insurance revenue, with the answer that passes. Built for Series A and B diligence.
Renting forever vs owning by year one
Rental fees do not step down. Ownership fees do. Run both on your numbers in the calculator. See the cost of building insurance operations in-house.
Own the contracts, not the rental
Questions, answered
What does it mean to own your payer contracts?
The participation agreements sit in an entity you control, with portable payer contracts and billing under your own entity. Network rental vs owning contracts is the difference between a lease fee and an asset you can take to diligence or a sale. Anvil launches you on rental, then migrates you.
Why would I want to own contracts? Isn't that the work I am outsourcing?
You outsource the work, not the asset. Anvil does the contracting for your entity. You end up with a company that holds its own payer relationships when you raise or sell.
Does building my own PC slow down the launch?
No. It runs in parallel and never gates your go-live. You bill through our PC first and through yours as each contract comes live.
How long does the migration take?
Typically 6 to 18 months depending on states and payers. Commercial contracts for a new entity often land in 4 to 8 months. Medicaid managed care varies by state.
What happens to claims in flight during migration?
Nothing changes for them. Claims billed under our PC are paid to our PC and remitted to you. New visits are routed to your PC once its contract with that payer is effective.
What do we end up with?
Your own PC, a physician owner under a friendly-PC structure, executed MSO and PC agreements, payer contracts in your entity's name, credentialing files for each clinician, and the rate history.
What if we leave Anvil after migration?
The contracts stay with your PC. Your MSO agreement with your PC stays in place. You would need an RCM and credentialing vendor, which is a normal vendor switch, not a relaunch.
What will investors ask?
Whether insured revenue runs through an entity you control, whether payer contracts are assignable or would need to be re-signed in a sale, and whether a single vendor could terminate your network access. Owning your PC answers all three.
Does the platform fee change?
Yes. It steps down as volume moves to your own contracts, because we are no longer carrying claims risk on that volume.
Is a friendly physician owner really mine?
The physician owns the PC under agreements that give your MSO the management rights and economics permitted in that state. Foundry PC has placed physician owners in these structures across the country.
Can we start with Build and add Scale later?
Yes. Most companies start on Build so the PC is forming while they launch, then move to Scale when they are ready to contract their entity.
Should I rent a PC or build my own professional corporation?
Do both, in order. Renting a PC gets you billing in weeks because the payer contracts already exist. Building your own PC is how you end up owning the contracts, but new commercial contracts commonly take 4 to 8 months. Anvil launches you on our PC and forms yours in parallel, so building never delays revenue.
Who owns the payer contracts when you use a telehealth insurance billing vendor?
It depends on the model. Network rental means the vendor's professional corporation (PC) holds the payer contracts and you bill under an entity you do not control. Anvil launches you on our credentialed PC, then files applications in your own PC's name. The contracts that land in your PC stay with your PC if you switch vendors.
What is network rental in telehealth, and what are the risks?
Network rental means you bill insurance under a vendor's professional corporation and its payer contracts. It is a fast way to launch. The risk is that you never hold the contracts: the vendor can end your network access, and investors will ask whether your insured revenue runs through an entity you control. Anvil rents to launch, then migrates you.
Rent for speed. Own for the asset. Start both today.
Tell us your states and clinicians. We will map the migration month by month.