HRGi Helps Manage the Cost of Large Network Claims
(Orange, California) Primary network discounts are fundamental to effective management of medical claim expense. Nevertheless, a disproportionate amount of claim expense can be attributed to just a few large in-network claims, in particular those exceeding $100,000 in charges. In response to this specialized need, HRGi has developed a process for scoring these bills, intervening with the billing entity and securing additional discounts with hospital authorization.
Ron Gray, HRGi's President and CEO shared these thoughts, "When a network contract exists, most health plans will pay even the largest claims without further intervention. They don't realize that many facilities, in response to a professional intervention on extraordinary claims, will agree to additional adjustments." Activating HRGi's network bill negotiation is a simple process and, due to the relative size of such bills, the impact can be significant.
"Our customers are surprised and pleased with these incremental savings to their in-network claims," shares Paul Nappi, HRGi's Vice President of Sales and Account Management. "We look forward to continued success with this in-network intervention program, as we continue to build our provider database."
About HRGi
A Principal Financial Group subsidiary, HRGi provides cost management services to healthcare payers and administrators by helping control out-of-network (OON) claims expense. HRGI customers include insurance carriers, third party administrators, health maintenance organizations, Taft-Hartley organizations and self-insured employers. HRGi's service portfolio includes OON claims management, fee negotiation, supplemental network management and cost-based fee repricing. Explore HRGi's value proposition at www.HRGi-Online.com.
