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Network Solutions

We help you solve the challenge of out-of-network costs while reducing provider abrasion.


A balanced approach

To maximize savings, we use:

  • Medicare benchmarking
  • Prospective inpatient claim review
  • Negotiation 

We assist in setting up Medicare benchmarking allowance as final out-of-network payment for high-volume, lower-dollar bills. Our prospective inpatient claim reviews and negotiation focus on: 

  • High-dollar billing errors and issues
  • Duplicate charges
  • Plan exclusionary denials
  • Facility sign-off

Our experts assist in setting up a defensible out-of-network strategy that includes high-dollar and high-volume claims.

Network Solutions results

  • 65% average savings of clients using a Medicare referenced-based position
  • Over 90% uphold on appeals

How are our Network Solutions unique?

We ensure minimal provider abrasion with our consulting on plan language. We provide appeal support on all claims repriced, and a full-service report portal showing results.

Plan language and custom rule, 65% savings, full appeals support, client reporting portal

Add Network Solutions to your payment integrity portfolio today.