Q: Does HHC provide cost reduction services for in-network claims or out-of-network claims?A:
We provide cost-reduction services for any type of claim, regardless if the provider is in-network or out-of-network, including claims from hospitals; outpatient services, ambulatory surgery centers and imaging centers; medical equipment companies; rehabilitation and physical therapy providers; dentists; and all types of physicians.
Q: How long does it take to negotiate or reprice a claim?A:
We typically turn around claims negotiation and claims repricing services within an average of 5 business days – and usually faster – so you never forfeit your ability to dispute provider charges and achieve maximum savings.
Q: Does HHC negotiate Air Ambulance, Emergency Department and other claims covered under the No Surprises Act?A:
Yes. HHC starts negotiating settlements with providers for all types of NSA claims as soon as the payer receives and sends us their claim. Settlement time is usually within 5 business days for less.
Q: Does HHC reprice workers' compensation claims to the state fee schedules?A:
HHC reprices workers' compensation claims in 33 fee schedule states and can add states to meet client needs.
Q: How long does it take for HHC to reprice workers' compensation claims to the fee schedules in fee schedule states?A:
HHC reprices almost all workers' compensation claims in fee schedule states in 1 business day.
Q: How does HHC negotiate/reprice workers compensation claims?A:
In fee schedule states HHC negotiates and reprices claims below the fee schedule. In non-fee schedules states HHC negotiates workers' comp as we would any other claim.
For workers' compensation claims in states that do not adhere to a fee schedule, we seek the maximum discount possible using our "never give up" approach and two decades of negotiation and repricing experience.
Q: What if we only want to use some of HHC's services?A:
We're flexible! That means clients can use only the services they require. From Negotiation to Medical Bill Reviews to Medicare-Reference Based Pricing, you can determine the specific services you want us to deliver as well as the precise claims that you want us to handle.
Q: What kind of independent/utilization reviews does HHC provide?A:
HHC Group is a URAC accredited Independent Review Organization: Comprehensive Review (Internal and External).
We serve as an IRO in many states to provide independent medical reviews when patients/plan members appeal the decisions of their insurance company to access care or medication.
We also frequently work with workers' compensation insurance companies to provide reviews related to injury causation, responsibility for coverage, level of disability, and when a patient can return to work.
With experts representing almost every type of medical specialty, we can handle virtually any medical review scenario, including those with urgent, time-sensitive requirements.
Q: For what kind of claims does HHC use Medicare-Reference Based Pricing?A:
Clients can choose which claim types they want us to apply Medicare-Reference Based Pricing. Payers can offer this pricing approach for all claims for Medicare-covered services, out-of-network claims, for hospital or physician claims only, or for specific medical services like dialysis.
Q: Does HHC Group reprice qualified End Stage Renal Disease (ESRD) patients' claims to a multiple of the Medicare rate.A:
HHC Group reprices qualified ESRD patients' claims to the multiple of the Medicare rate designated by the individual's Group Plan. HHC Group charges only a flat fee per treatment rather than a percentage of the savings maximizing the Group's net saving on these claims.
Q: How can I submit claims to HHC?A:
The easiest, most efficient way to submit claims is to upload them on our secured computer server through our online portal. Registration is easy. Click here to get started.
You may also submit claims by secure email to email@example.com, via the H.H.C. website or by fax to (301) 963-9431. For Negotiating, Repricing, and Medical Bill Reviews, you may submit to firstname.lastname@example.org
. For Independent Reviews/Utilization Reviews, you may submit to MRP@hhcgroup.com.
If you are submitting a large number of claims, we recommend establishing an EDI connection.