COALITION AMERICA UPDATE
Medical Bill Negotiations - An Integral Piece of Your Cost-Containment Plan
www.CoalitionAmerica.com
When considering cost containment solutions for medical bills, don’t stop at PPOs. There are a number of options to decrease your risk and increase your bottom line. Medical bill negotiation can create a positive result for both healthcare providers and payors of medical bills.
Negotiating is nothing new. Negotiating on medical bills isn’t new either. But there are more aspects to medical bill negotiating than meets the eye.
Any Claim Size Negotiations
Many companies that offer medical bill negotiation services will only work with payors on claims with charges above a certain dollar threshold. The industry average starts at $1,500 and is even higher with some companies. While many dollars can be saved on high dollar medical claims, the aggregate dollar amount of smaller claims can total tens of millions of dollars for many payors. Why would you not look for a medical bill negotiation company that can handle both your high dollar and low dollar claims?
Coalition America (CAI) handles any size claim, regardless of the dollar amount. Through its proprietary processes, CAI is able to leverage technology to negotiate claims that other companies would typically not even consider handling. CAI can illustrate to providers the current patient volume by aggregating all claims for different payors in order to obtain the best savings for their clients. Overall greater savings for the plan and the members result when medical bill negotiations are leveraged from the very first healthcare dollar.
Prospective Negotiations
Patients facing organ transplant procedures or other major surgeries will undoubtedly accumulate an overwhelming cost in medical bills. Balancing the care of those patients along with the costs of the services they require can be a daunting task. Let CAI work closely with your case management or utilization management teams to allow the UM teams to focus on the patient’s care while CAI manages the negotiations on upfront costs for prescribed services. The best time to negotiate with a provider is before the services are rendered to the patient. There will always be greater savings for these services compared to post-service negotiations.
Consumer Negotiations
Enrollment in HSA and MSA accounts continues to grow, and more and more consumers are choosing minimum healthcare coverage for their families. This has created a greater need for patient education on how to manage costs for medical services. Many patients are unaware that a reduced fee from their healthcare providers can be negotiated when they are financially responsible for a healthcare visit. CAI now offers a consumer negotiation service in which we act as a patient advocate with the provider and attempt to negotiate a lower out-of-pocket expense for the patient. This allows the patient to extend the money they have for healthcare services and allows providers to work with the patients for a reduced payment.
When you look for companies to perform medical bill negotiation services for you, be sure to look for the full spectrum of services such as the ones described above to deliver the greatest possible savings to you and your members.
For more information on Coalition America's medical bill negotiation services, please contact your Coalition America account manager or Sales@CoalitionAmerica.com.
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