BRIDGING THE GAP BETWEEN PAYERS AND PROVIDERS
Designing client-specific workflows and solutions that maximize results by leveraging a wide range of healthcare cost containment services and extensive industry expertise. We develop industry-unique product and service configurations to achieve seamless, optimal outcomes resulting in fair reimbursements for payers, patients, and medical providers.
Medical Bill Negotiation
OccuNet's team of expertly trained, experienced, and motivated negotiators continually strive to provide excellent service levels and deliver industry-leading results to our member, provider, and payer clients, utilizing our proven industry-unique methodologies and strategies.
OccuNet has the experience, resources, and capabilities required to proactively negotiate treatment and procedure prices before and after they occur. This solution establishes and secures rates for complex and ongoing treatments on a patient-specific case-by-case basis.
Precision Claim Review is a seamless proprietary analytical tool combining key components of code editing, bill review, compliance review, and industry benchmarks and reference points. It’s a key part of our cost management plan.
In addition, complex cases may be eligible for our additional clinical review and assessment. This process enables the OccuNet team to ensure the best outcome, resulting in secured savings and protecting members from any balance billing.
Long-Term Provider Agreements
A primary strategic initiative for OccuNet is to continuously secure and establish long-term agreements with select providers for our clients. These agreements allow OccuNet to minimize turnaround time and handle client claim volume more effectively.
The simplicity of provider agreements increases employee engagement in healthcare and group plans. This process also benefits providers by reducing administrative work on their end.
OccuNet has signed more direct agreements with Air Ambulance providers than any other healthcare cost containment organization. Our strong commitment and focused strategy to Air Ambulance has resulted in OccuNet being at the forefront of secured discounts in this unique healthcare market segment.
With our extensive proprietary data, we have established the most robust, credible, and defensible national QPA schedule in the country for Air Ambulance services.
PPO Network Services
OccuNet offers a national supplemental/wrap network solution that can supplement & augment the overall strategy and value proposition for our clients through secured contractual agreements.
Established Reimbursement Level
OccuNet has developed an in-house proprietary established reimbursement level (ERL) solution to reprice non-contracted claims that can be utilized as a part of a comprehensive out-of-network strategy.
Industry Leading. Envelope Pushing.
The Nation's Best Medical Bill Negotiation Team, Period.
We work with you to design and implement solutions tailored to your specific needs. OccuNet supports electronic and manual workflows and operates in a secure environment that exceeds industry-standard IT infrastructure and HIPAA-compliant data security protocols.
Provider Specific Solutions
We simplify and streamline the healthcare claim flow process with our select provider partners. Resulting in a fair reimbursement for patients, payers, and providers.
- Direction of care
- Dedicated provider advocate
- Electronic transmission
- Easily identify group (ID cards)
- Simplified credentialing
WHERE WE WORK
- Group Health
- Accident & Health
- Workers' Compensation
- Auto Liability
Bridging the Gap Between Payers and Providers.
Collaborate with providers to ensure they receive prompt and fair compensation for the services they provide.
Build true relationships with providers to help ease the payment process.
Driving clients to our preferred partners through member education, plan design, and technology.
Ensure accurate payments from direct agreements that result in faster turnaround times.
Dedicated provider advocates to handle all provider inquiries.
Provide transparency with no red tape or hoops to jump through
Is your employer healthcare really worth what you pay?
See Our Fresh Approach to RBP
SOLUTIONS - TECHNOLOGY - SERVICE - RESULTS
Ready to take control of your healthcare costs?
Contact The OccuNet Company.