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Claims Negotiation and Repricing

Claim Negotiation and Repricing

Medical bills for the same services can vary by tens of thousands of dollars from one provider to the next. Sometimes, the same provider will bill wildly different prices for in-network vs. out-of-network claims for the same services. In addition, many provider bills include mistakes, erroneous disease codes, or unbundling that artificially inflate the amount due. That's why we offer our clients a wide range of services designed to significantly reduce their healthcare spend.
Claims Negotiation
Upon receipt of your medical claims, our team of skilled attorney negotiators goes to work to resolve the case using our 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 more than twenty five years of negotiations with the provider or similar providers in the same market - published databases and their many years of negotiating experience, our skilled negotiators work collaboratively with the provider to achieve a mutually acceptable resolution, one that results in our clients paying only an appropriate for the services their employees/members receive.

Importantly, the provider supplies signed confirmation that the negotiated amount is payment in full eliminating any balance billing or lost discounts.
Claims Repricing
HHC has established relationships with major national, regional, and local preferred provider networks (PPOs). When our clients submit out-of-network claims, we can often reprice the claims to the significantly lower, pre-negotiated rates which providers in these networks have already agreed. For larger claims we double check with the network to confirm that the provider is currently contracted with them and that the discount taken is correct minimizing the potential for any reversals.
The HHC Group Guarantee
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.
Other Cost Containing Services
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, Referenced-Based Pricing, and more. Click here to learn more.

Case Studies, News, & Insights

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New Grandfathered Health Plan Final Rule Will Allow Higher Consumer Costs