“HPC has developed a “dream team” of highly experienced medical claim negotiators and nurses………Future products include buying or building a PBM for our clients and operating it at cost. The goal is to shift the profits from PBM’s to Payers and their clients in the same way that we are doing with Large Dollar Claims.”
HPC is a member-owned innovation company that combines the benefits of in-sourcing, outsourcing and innovation management for Healthcare Payers. Our mission is to utilize our unique business model to eliminate third party profit stacking and shift those profits back to Payers and their clients. Our initial focus is on large dollar claims negotiation services.
HPC has developed a “dream team” of highly experienced medical claim negotiators and nurses. Every nurse, negotiator and supervisor has at least 10 years experience in cost containment and large dollar claims negotiations. The account team reviews EVERY claim and uses an extensive library of industry cost and performance benchmark data to ensure the maximum discount is achieved.
Our claims negotiation deliverables include:
- ASSIGN an experienced and dedicated negotiation and account management team to the account
- PERFORM a clinical assessment on all claims as part of the negotiation process
- PROVIDE account with periodic updates on all open cases
- PROVIDE a Patient Advocate with access to legal counsel throughout the process (as needed)
- PROVIDE a Repricing Sheet the same day an agreement was reached in the negotiation
Fast Start allows Payers immediate cost reductions and larger discounts. Payers also receive a sneak peak into the transparent methods used by HPC to eliminate the huge fees charged by traditional cost containment companies.
- No investment required. No long term commitment.
- Thresholds: $125,000 in network | $20,000 out of network
- All discounts secured through corrected claim or sign off