OCCUNET SOLUTIONS

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OCCUNET SOLUTIONS
Active Precision Claim Review
Inactive Precision Claim Review

Payment Integrity

Active Precision Claim Review
Inactive Precision Claim Review

Fee Negotiation Services

Active Precision Claim Review
Inactive Precision Claim Review

Pre-Service Negotiations

Active Precision Claim Review
Inactive Precision Claim Review

Targeted Long-Term Provider Agreements

Active Precision Claim Review
Inactive Precision Claim Review

Reference-Based Pricing

Payment Integrity

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.

precision claim review

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.

precision claim review

PRE-SERVICE NEGOTIATIONS

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.

precision claim review

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.

precision claim review

REFERENCE-BASED PRICING

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.

precision claim review

Fairos, powered by OccuNet, is a proven healthcare strategy that replaces conventional PPO plans. Self-funded employers use Fairos to take control of their rising healthcare costs. Our proactive approach with medical providers produces fewer balance bills, resolves them faster, and delivers the best member experience in the industry. Interested in full network replacement? Visit Fairos.com