“HST realizes that not all highly inflated claims will result in a fair and reasonable payment arrangement with the provider. Egregious claims reviewed by HST that are not mutually resolved can be directed to our network of law firms. We also have a Patient Advocacy Center (PAC) that provides a coordinated and collaborative roll between the payer, provider and member. HST ‘s expertise on the pricing and reimbursement cost is included at no additional fee. Supporting policy language significantly improves the results based on objective industry metrics.” www.hstechnology.com
OVERVIEW
Since 2009, HST has been at the forefront of providing referenced-based pricing (RBP) technologies that reduces healthcare claims cost. We believe that combing pricing and quality can effect meaningful change in purchasing medical services and containing costs. Timely access to reliable cost and quality information is indispensable in determining the economic price of reimbursements. We are dedicated to providing transparency to payers so we can design effective reimbursement strategies.
Our Mission is clear…
Providing our clients with meaningful, timely, and accurate information as it pertains to price, cost and quality of medical services resulting in increased cost savings.
Clients – HST’s clients consist of: Health Plans, TPAs, Trust Funds, Stop Loss Carriers, MGUs, Specialty Risk Insurers, and Self-Administered Group Health Plans.
REFERENCE BASED PRICING & CLAIM SURVEILLANCE
Our proven innovative pricing technologies allow healthcare payers to optimize reimbursements for all healthcare transactions by benchmarking claims. The pricing engine utilizes extensive data sets to determine the prevailing price, cost and value for all medical services. Claim surveillance examines every claim automatically and benchmarks results against Medicare pricing, cost, average reimbursements, commercial claim payment, reasonable and customary databases and proprietary data bases. This is our Turn-key claims cost management solution.
Once the prevailing price is established, our seasoned negotiators present the findings to the provider and secure a negotiated sign-off agreement based on the reduced amount. This ensures payment-in- full with no balance billing to the member.
- HST provides pricing data services to support your cost containment solutions. Our pricing and cost data allows you to benchmark against Medicare pricing, costs and our proprietary databases with tailored results based on your risk tolerance. We can customize our solution to meet your needs and turn-around times.
- Our medical appropriateness looks for redundant & duplicate charges, unbundling, experimental drugs, capital equipment, routine nursing, inappropriate charges, unidentified and incomplete charges. Claims requiring further investigation are flagged for specialist review.
REIMBURSEMENT STRATIGIES:
To protect our clients even further, we provide plan/policy document consultation to make sure the plan language supports our pricing and reimbursement efforts. Our language was developed to support RBP that establishes an objective reimbursement methodology based on recognized industry standards. We believe our clients’ plan language needs to be beneficial for both the plan and member.
HST realizes that not all highly inflated claims will result in a fair and reasonable payment arrangement with the provider. Egregious claims reviewed by HST that are not mutually resolved can be directed to our network of law firms. We also have a Patient Advocacy Center (PAC) that provides a coordinated and collaborative roll between the payer, provider and member. HST ‘s expertise on the pricing and reimbursement cost is included at no additional fee. Supporting policy language significantly improves the results based on objective industry metrics.
