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Claims Negotiation and Repricing

Medical bills for the same service can vary by tens of thousands of dollars from one provider to the next. And even the same provider may bill wildly different prices for in-network vs. out-of-network claims. In addition, provider bills may include mistakes, erroneous disease codes, or unbundling that artificially inflate the amount due. That's why HHC offers clients a wide range of services to reduce their healthcare spend.

Plus, we guarantee to turn around Claims Negotiation and Repricing services in five days or less always with a sign-off from the provider, so the price we negotiate stays firm.

Claims Negotiation

Upon receipt of your medical claims, our team of skilled negotiators goes to work to resolve the case using a proven approach. Our team works directly with the providers from hospitals, to doctors' offices, to imaging centers. If the provider issues a bill, our team will work with them.

Using a proprietary database of pricing information gathered over two decades of negotiations with the provider or similar providers in the same market and published databases, our tenacious negotiators work collaboratively with the provider to achieve a mutually acceptable resolution.

Claims Repricing

HHC has established relationships with major national, regional, and local provider networks (PPOs). When our clients submit out-of-network claims, we can often reprice the claims to the pre-negotiated rates which providers in these networks have already agreed.

In addition to Claims Negotiation and Claims Repricing, HHC Group offers a full continuum of services to reduce the cost of your claims, including Medical Bill Review services. Click here to learn more.