Payor Solutions

Real People. Real Savings. Real Results for Payors.

Whether you manage a self-funded health plan, stop-loss carrier, TPA, or government agency, H.H.C. Group is your trusted partner in navigating claim complexity, reducing spend and ensuring compliance.

Explore Our Services:

Cost Containment Solutions

• High-Dollar Claims Negotiation
• Line-Item and Comprehensive Bill Reviews
• Medicare Reference-Based Pricing (RBP)
• Out-of-Network Claim Repricing
• DRG Validation

Independent Medical Reviews (IMRs)

• Internal Reviews: Pre-service and appeal-level evaluations to guide coverage decisions and reduce overturn risk
• External Reviews: URAC-accredited, state-assigned or plan-authorized final determinations trusted by 33 states

IDR (Independent Dispute Resolution)

• NSA-compliant resolution of surprise billing disputes
• Detailed position statements and documentation
• Support for both state-assigned and direct-to-IRO pathways

Why H.H.C. Group?
✔ URAC-Accredited IRO
✔ ISO 9001:2015 Certified
✔ 30+ Years of Experience
✔ Proven Savings, Faster Turnaround

Ready to control costs and protect your plan integrity?
Contact Us for Payor Services