Re-Pricing Out of Network Claims

ProPeer clients report that 7% to 10% of all claims received are OUT OF NETWORK. No matter the size of your department, you cannot afford to pay out "out of network" rates.

NEGOTIATING OUT-OF-NETWORK CLAIMS

Claims are analyzed prior to negotiation for error, unbundling, proper CPT coding and appropriateness of services. A signed Agreement is obtained from the provider and forwarded to you for your records. Negotiated Out of Network claims are currently averaging 3 to 5 day (in house) turn around time with savings of approximately 13%*.

For more information about ProPeer’s out of network claims services, or other medical peer reviews services, please contact us.

* The savings listed above are only an average. ProPeer Resources cannot guarantee any savings on the claims submitted for Peer Reviews, Hospital Bill Audits, Re-Pricing or Negotiation.

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