Claim Negotiations

 

Provides savings through the negotiation of physician and hospital claims.

American Health provides additional savings for clients by negotiating discounts on bills from out-of-network providers.  Our Out-of-Network Repricing Department will contact the provider and attempt to negotiate a discount from billed charges.

 

Fast Facts

• Negotiated discounts can result in savings of 15-25%.
• American Health has a negotiation success rate of 65% on hospital claims and 82% on physician claims.
• We have regional Usual and Customary Reductions (UCRs) that can be used to aid in the negotiation process.
• A 24-hour prescreening of claims determines the most appropriate procedure for receiving a discount.
• Providers recognize and respect the American Health name, and are willing to work with us.
• American Health’s Negotiations team calls on claims at least once a day.
• We can provide on-site AND off-site audits for negotiation purposes.
• Turnaround time is client-driven, but best results are achieved if we are given 5-7 days to negotiate a claim.