Maximizing Savings On Medical Claims
Sometimes, providers bill more than is appropriate for the services they deliver. When they do, our self-insured clients have us negotiate discounts on their out-of-network claims and on larger in-network claims (when it's allowed) and we excel at it. Our attorney negotiators start by examining each claim to identify any obvious errors.
They then determine the appropriate amount to pay for the services provided based on published databases and HHC's proprietary database detailing our history with the provider, giving them a starting place for their negotiations.
Armed with this information, they contact the provider, make their way to the decision maker and, taking a consultative approach, secure a signed agreement from the provider to accept the negotiated amount as payment in full.
LEARN MOREWhen it will maximize our clients' savings or if we are unable to negotiate a settlement with a provider we turn to our national, regional and local preferred provider network (PPO) partners. We tap their agreements with over 1.2 million professionals and 6.5 thousand facilities to accept discounted rates as payment in full for their services. Importantly, we customize network routing to maximize client savings. We also validate the discounts on very large claims to avoid costly reversals--all within 5 business days. HHC can help with:
The government and commercial insurers spend an estimated $298.5 billion in hospital costs annually. Per capita hospital expenditures in the U.S. are 50% higher than those in all but one other industrialized nation. The percentage is even higher for private insurers who pay 40% of all hospital bills.
Provider consolidation continues unabated and, as a result, prices for health care just keep rising. Research shows that consolidation is leading to significantly higher prices for private insurance, but not an improvement in quality for patients.
A professional health care price gladiator says negotiating conditions seem to be about the same as they've been for the past 20 years, when he first climbed into the arena. Prices continue to be all over the place, and the providers' willingness to bend on price also continues to be highly variable, according to Bruce Roffe, president of HHC Group.
Commissions, as a percentage of your clients' premiums, likely comprise the lion's share of your income. So it's only logical that when your clients' renewals roll around, you present them with options from a short list of conventional, fully-insured health plans – similar to their existing coverage.
© 2023 HHC Group. All Rights Reserved.
Maximizing Savings On Medical Claims
© 2023 HHC Group. All Rights Reserved.