电车无码

Software

Integrated Repricing Network

A solution for out of network claims that accesses 50+ national and regional PPO networks through a single interface, and uses routing optimization to achieve maximum savings.

Out-of-NetworkClaim Repricing

  • Integrate seamlessly听with 50+ national and regional PPO networks through a single interface.

  • Can be combined with additional layers of claims cost management technology, including clinical code edits and Record Review logic, prior to claim routing.
  • Uses proprietary听routing optimization to achieve maximum savings.

  • The ability to customize out of network claim management using three primary repricing models,听including PPO Repricing, Cost-Based Fee Negotiation Services, and Reference Based Repricing.

Streamline Out-of-Network Repricing

  • Out-of-network PPO management

    • Provide access and EDI repricing to our AccessPlus Supplemental PPO Repricing program for the management of claims that fall out of the primary network. This program includes 50+ PPO Networks totaling access to over 4,500 hospitals and 900,000+ provider locations nationwide.
  • Cost鈥恇ased fee negotiation services

    • Establish a baseline for fair and rational reimbursement with cost鈥恇ased benchmarks that can be utilized for both in鈥恘etwork and out鈥恛f鈥恘etwork claims.
  • Reference-based claims repricing

    • Alternative solution to price out of network claims using reference based repricing models. Can be used to gain savings on claims that fall outside of repricing networks, or provide additional savings to available repricing.

Providing Measurable Value

Card Background
24 %

per claim repriced in average supplemental PPO savings

Card Background
30 %+

average fee negotiation savings with sign off

Card Background
50 %+

average Medicare+ repricing savings per claim repriced

Card Background
2-4 %

average reduction in annual claims cost

Our outcomes

View all insights

PRODUCT SUPPORT

Need support for
this solution?

Join Community discussions

Find and share knowledge, exchange ideas, and collaborate with peers and 电车无码 experts to drive your solutions to success.

Let鈥檚 start a conversation

We鈥檙e here to help you find out how our services could benefit your organization. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information about our services? Start here.

Thank You

We appreciate your interest in 电车无码. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.