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.


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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