Solutions / Out-of-Network Solutions

Out-of-Network Solutions

Use a balanced, flexible approach to out-of-network savings.

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Out-of-Network Solutions

Gain control over the rising cost of out-of-network claims.

  • Balance savings with provider acceptance
  • Put key savings opportunities to work
  • Set savings goals and parameters based on plan or company guidelines and tolerance
  • Leverage clinical, technical and regulatory insights
  • Leverage a dynamic optimization engine with customizable rules to automatically route claims to the best savings channel
  • Stay ahead of evolving surprise billing and cost transparency regulations
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Claims Negotiations

Achieve pre- and post-payment savings through provider relationships, coding expertise and historical benchmarks.

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Market-Based Pricing

Maximize acceptance and minimize appeals with a pricing strategy that improves transparency, reduces provider abrasion and drives savings.

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Specialty Networks

Reduce plan and network costs with coverage for specialty providers including behavioral health, OT, PT and chiropractic care.

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No Surprises Act / Transparency in Coverage

Gain the insight and tools you need to comply with new balance billing and transparency regulations set to take effect beginning in 2022.

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Testimonials

Market-Based Pricing in action.

Take the Next Step

See the difference our balanced approach will make with your out-of-network claims.

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