Timely communications with our clients and persistence with providers are two of the hallmarks of HHC claims negotiation. In this case, our Case Manager worked her way to the decision-maker in the executive office of the provider, communicated the progress being made to the client and got an extension past the normal 5 day window for negotiating claims.
The result - A signed agreement that saved the group $518,483.
Patient was admitted for congestive heart failure (CHF), respiratory and kidney failure, gastritis with bleeding, A-fib, and malnutrition
PPO Discounted Charge (% Discount):
HHC Adjusted Charge:
% HHC Savings versus List Charge:
Client Savings: $518,483