Big Oncology Bill. Bigger Savings. $403K Claim Reduced by 90% — Employee Cost: $0

A self-funded health plan fulfilled its obligation on a high-cost, out-of-network hospital claim tied to complex cancer treatment. The provider accepted the payment—but then issued a $310,308.59 balance bill to the patient, creating significant financial burden and escalation risk for them.

The patient turned to the TPA for support, who then engaged H.H.C. Group to intervene. Through targeted negotiation, H.H.C. Group reduced the patient's obligation by 90%—from $310,308.59 to $31,030.85—which the group paid in full, eliminating the member's responsibility entirely.

The patient won. The plan won. The TPA won.

• Patient: 57-year-old female
• Setting: 25-day inpatient hospital stay
• Treatment: Chemotherapy for cervical cancer with lymph node involvement

The group had already paid $92,891.41 toward a $403,200 billed claim.

However, the provider continued to pursue the member for the remaining $310,308.59, exposing the plan to reputational risk and the member to substantial financial liability.

Without intervention, the claim would result in:

• Excessive out-of-network overpayment
• Member balance billing exposure

H.H.C. Group conducted a comprehensive review and strategic negotiation to secure a signed agreement, eliminating member balance billing

This hands-on approach ensured the claim was evaluated both financially and clinically delivering a fair, defensible outcome.

• Billed Amount: $403,200.00
• Original Plan Payment: $92,891.41
• H.H.C. Group Negotiated Payment (Final Resolution): $31,030.85
• Total Client Savings: $310,308.59
• % Saved vs. Billed Charges: 90.0%

• ✔ Reduced employee responsibility from $10,308.59 to $0.
• ✔ Shrunk overall claim exposure to a fraction of original charges
• ✔ Delivered a fully negotiated, defensible resolution

High-cost claims impact both financial performance and the people behind every claim. In this case, H.H.C. Group eliminated a six-figure burden for the member and enabled the health plan to fully resolve the patient's obligation, delivering meaningful support to their employee.

With expert negotiation, clinical insight and a relentless focus on accuracy, H.H.C. Group delivers results that go beyond "savings"—they deliver confidence, protection and peace of mind.

Stop overpaying. Let H.H.C. Group show you what's possible.