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There is more savings to be had on in-network claims

Preparation

Negotiation

3 Step Process for Maximum In-Network Savings

Upon receiving the medical bill and itemization (if available) from our client, HealthGathered performs a preliminary review of the documentation to determine

  • Historical Negotiation Success

  • CFO Level Contact 

  • PPO Discount/Repricing Information

  • Potential Billing Errors

  • Potential Billing Overcharges

  • Claim Negotiation Strategy

Preparation

Once the negotiation strategy is determined, HealthGathered contacts the provider and schedules a call or web meeting to review the medical bill.  The following is reviewed 

  • PPO Discount

  • Potential Billing Errors & Overcharges

  • Potential for an Official Audit 

  • Expedited Payment Opportunity and Terms

  • Shared Savings for Member

Negotiation

Once the provider has agreed to a settlement amount, HealthGathered prepares and sends a short but thorough Single Case Agreement which covers

  • Key Elements of Medical Bill

  • No Balance Billing Condition

  • Acceptance of Negotiated Amount 

  • Expedited Payment Terms

  • Waiver of Medical Bill Audit

  • Payment Remittance Information

Finalization

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