Prepayment Negotiation Module

Some payers are of the opinion that a claim should never be paid @ 100% of billed charges and out-of-network claims are a large expense for healthcare payers. The expert professional negotiators at DataMetrix work with out-of-network providers to obtain claim resolution that provides a significant savings to our clients.

• The claims received by DataMetrix are assigned to our skilled negotiators.
• Claims are reviewed on a line-by-line basis to identify anomalies and additional opportunities for savings.
• Providers are contacted and an agreed upon price is returned to DataMetrix via signed agreement.
• Signed agreement and applicable closing documentation is submitted to client.
• Claims are paid by client according to the new discounted price.
• Turnaround time 3 – 5 days.

Benefits

• Substantial savings

• Signed agreements on out-of-network claims

• No balance billing of members for discounted amount

• Exceptional provider relations