Client Success Story: Cardiac Arrhythmia Case

March 27, 2025 A 64-year-old male received complex cardiac care over a seven-month hospital stay at a Southeastern medical center. The provider billed $968,710.15 for a mix of inpatient care, diagnostic testing, and minor surgeries.

Challenge:

Despite being in-network, the claim posed a major financial burden for the health plan. While the PPO discount reduced the bill by 34.4% to $635,467.11, the remaining cost was still excessive given the scope of services provided.

Solution:

H.H.C. Group's attorney case manager—already familiar with this facility's billing practices—led negotiations using internal data and industry benchmarks to support a more appropriate payment. After 10 days of back-and-forth communication, the provider sent a signed agreement accepting H.H.C.'s negotiated offer as payment in full for the claim.

Results:

H.H.C. Group reduced the payment by an additional $174,367.83 beyond the PPO discount—cutting total costs by more than half.

Financial Breakdown:

• Original Billed Amount: $968,710.15
• PPO Discounted Amount: $635,467.11 (34.4% below billed amount)
• HHC Negotiated Payment: $461,099.28
• Savings Beyond PPO Discount: $174,367.83 (27.4%)
• Total Savings: $507,610.87 (52.4% below billed amount)

Real People. Real Savings.

This case showcases H.H.C. Group's ability to drive savings even on in-network claims with large existing PPO discounts. Through skilled negotiation, we delivered a 52.4% total reduction—proving the value of a second layer of savings on high-dollar in-network claims.

Want to unlock deeper savings on complex claims? Contact H.H.C. Group today.