For Out-Of-Network Claims
HealthMind offers negotiations of out-of-network claims as a supplemental service to the suite of services integrated under ReThink™. Dynamic Discovery™ embedded within the ReThink™ service suite identifies providers and claims that would have better results through negotiations based on historical outcomes within the each client’s unique provider claims. The HealthMind Negotiation team has developed a consistent and highly effective approach to out-of-network claims negotiation that is employed once a claim is identified. We have found that our approach not only maximizes savings and minimizes provider resistance; it also yields timely results at no risk to our clients.
We have discarded the “hard-nosed” negotiation model and developed a more efficient and effective approach. Instead of using aggressive tactics that often support short-term objectives, our team focuses on building positive provider relationships that ensure long-term success. In our negotiation process each claim is assigned to one of our expert negotiators responsible for overseeing its progress from beginning to end. Because we use the Medicare reimbursement rate as our bottom line figure, we are able to begin the negotiation process from a position of strength.
How It Works:
- All claims are first passed through the ReThink™ suite of services
- Claims are selected based on our dynamic discovery analytics
- Claims are examined using a clinical approach
- All negotiations are based on a thorough analysis of the claim detail
- All completed negotiations are accompanied by a signed agreement with the provider
- All results are documented and incorporated into the ReThink™ platform