Cost Management tactics are critical in today's insurance industry and HealthComp's Utilization Management Department established a Special Contracts Pricing Negotiations Unit to help do just this. When a member chooses or is forced outside of the Network selected by the Client, the facility or provider is not bound by any contract to keep costs at a reasonable rate.
Special Contract Pricing Negotiations are attempted on Non-Network claims processed at HealthComp. The amounts negotiated are standardized at $1000 for Professional and Facility fees, but any claims may be referred to the Unit for negotiations.
Our trained negotiators attempt to get a discount off of the claim incurred, on behalf of our Clients and to prevent the members from being balance billed after usual and customary pricing is applied. The Special Contracts Pricing Negotiations Unit will also attempt to establish direct contracts with Non-Network providers based on agreed upon criteria. If this cannot be done, then Single Patient Agreements are negotiated.