Out-of-Network Fee Negotiations & Repricing Overview

Our Fee Negotiation Services can help health plans save on out-of-network medical claim costs by working with facilities to reach agreeable terms and considerable discounts.

Our service yields signed agreements, no appeals, and stronger relationships between you and your providers and members.

Cooperative Strategy
All received claims are reviewed and settled directly with the provider or facility. Our audit nurses and professional coders review each claim for possible overcharges, inappropriate charges, billing errors, and excessive charges. Our services provide complete and transparent claim resolution.

Direct negotiation
We also use direct negotiation on a case-by-case basis, targeting inpatient, outpatient, and professional claims over certain agreed-upon minimums. Setting recommended claim thresholds minimizes administrative investment and maximizes the savings yield.