Out-of-Network Claims Repricing Solution

Sign in

Sign in

Product Applications
Find, access, and login to your product application portal as a current customer.

Use the �糵�� product support portals to submit support requests and find answers to your questions.

View your current quotes and finalize your order by logging into your Marketplace account.

Login to your community accounts to get product updates, ask questions, and learn best practices.
Support

Support

Get help with �糵�� products, find resources such as enrollment forms and payer lists, and quickly resolve common issues.

Find forms for medical claims, patient eligibility, ERA, and EFT payment information.

Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers.

Your online resource for healthcare regulations and standards.

Speak with customer support 866-371-9066
Contact

Select a Form

Contact Sales

Partnership Inquiry

First Name *

Last Name *

Business Email: *

Job Function *

Job Level *

Claims Volume

Company *

Company Type *

Practice Specialty

Number of Covered Lives

Practice Management Software Vendor

Business Phone *

Country *

State/Location *

Comments/How can we help?

Subscribe to �糵�� Communications

Web Analytics

Web Analytics

Speak with a Sales agent

1-866-817-3813

If you're interested in partnering with �糵��, please fill out the form below and we’ll be in touch soon.

We have a long history of helping clients, customers, and partners navigate the changing landscape of healthcare.

First Name *

Last Name *

Email Address *

Business Phone *

Company *

Country *

State or Province *

Address 1 *

Company Website

Company Profile *

What best describes what you would like to learn more about?

What type of products or services does your company provide?

Type of partnership interest? *

How would you describe the opportunity for partnership between our two organizations?

Who are the targeted end users? *

Area of interest for this partnership?

Do you have other business relationships with �糵��? *

Contacted us previously about this partnership inquiry?

If you have contacted us previously concerning this partnership inquiry, include a list of people within �糵�� with whom you have already been in contact.

Comments

address2

Speak with a Sales agent

1-866-817-3813

Thank You
��

We appreciate your interest in �糵��. 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.

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.

��

Contact Sales

Out-of-NetworkClaim Repricing

Integrate seamlessly��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��routing optimization to achieve maximum savings.
The ability to customize out of network claim management using three primary repricing models,��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‐based fee negotiation services
- Establish a baseline for fair and rational reimbursement with cost‐based benchmarks that can be utilized for both in‐network and out‐of‐network 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

24 ^%

per claim repriced in average supplemental PPO savings

30 ^%+

average fee negotiation savings with sign off

50 ^%+

average Medicare+ repricing savings per claim repriced

2-4 ^%

average reduction in annual claims cost

Our outcomes

View all insights

Infographic

We Deliver So You Can. The Streamlined Patient Communications Solution

Infographic

We Deliver So You Can. The Streamlined Patient Communications Solution

Learn how a platform for the full spectrum of patient communications accelerates revenue, lower cost-to-collect, reduce bad debt and boost the patient experience.

Learn More