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Precision Claim Review is a seamless proprietary analytical and payment integrity 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.
FEE NEGOTIATION SERVICES
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. Negotiated fee health insurance and strategic cost management save you and your payers money.
OccuNet has the experience, resources, and capabilities which are essential to proactively negotiate pricing for treatment and procedures before they occur. This solution establishes and secures rates for complex and ongoing treatments on a patient-specific case-by-case basis. Our proactive approach saves more time and money than medical reimbursement.
TARGETED LONG-TERM PROVIDER AGREEMENTS
A key strategic initiative for OccuNet is to continually secure and establish ongoing negotiation agreements with providers for our clients. These agreements are comprised of key providers, enabling OccuNet to minimize turnaround time and more effectively manage client claim volume. 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 developed an in-house Medicare reference-based pricing solution. This product can be utilized as part of a comprehensive out-of-network strategy or as a full network replacement through our reference-based pricing solution, Fairos.
Provider Network Repricing 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.