SOLUTIONS FOR

Insurers, TPAs,
& Corporate Payers

Results Delivered.

35%

Save 35% or more on most

20%

Negotiating just 5% more savings on claims can increase your profitability by 20%

100%

100% of negotiation evidenced with sign agreements to lock in

0

Zero arbitration record on

Common Industry Challenges

Extract more savings and value from your out-of-network claims.

  • Non-participating providers are finding ever more creative ways to increase reimbursement and charge more.
  • 89% of your clients’ medical decisions are made without knowing the cost or network status.
  • When there are no networks or established market baselines, healthcare providers commonly overcharge for medical services.
  • Out-of-Network claims are typically less than 15% of volume yet can drive greater than 25% of costs.
  • Some large payers are reducing the number of vendors to manage fewer relationships. However, a “best-of-breed” approach—deploying vendor experts—yields 25% more in benefits.
  • By attempting to increase throughput speed, payers leave up to 20% of costs unmanaged.
  • You may be optimizing speed but sacrificing savings and stakeholder value. Drop-in networks often sub-optimize savings for ease of application.

Recommended Services

Payer Claim Negotiation

Prospective Negotiation

U.S. Medical Tourism

FOR MORE INFORMATION ON OUR INDUSTRY SOLUTIONS, CONTACT WITH US TODAY!

Our Value Proposition

Medical Cost Advocate’s services help healthcare payers optimize their out-of-network claims processing to realize more savings. Implementing a “best-of-breed” approach by engaging a focused negotiation expert to reduce your claims costs will typically yield 25% more in savings. MCA is your expert medical cost reduction partner delivering professional negotiators armed with proven processes, proprietary data, and more than 20 years of negotiation experience to help you extract the most savings from claims.

  • All negotiations are attorney performed, reviewed, or managed.
  • Our multi-year relationships with providers enable us to realize better results.
  • Each negotiation is evidenced with our proprietary signed agreement.
  • MCA has a zero-arbitration record with its proprietary agreement
  • Seamless integration into your workflow. Flexible and scalable interface options.
  • MCA negotiates bills for thousands of consumers in all 50 states and internationally, yielding detailed cost data and relationships that enhance our negotiation outcomes.
  • We also leverage proprietary networks and establish quasi-networks based on past outcomes.
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We will create a negotiation competency for your firm.

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Who Will Benefit?

We can help almost any payer achieve better results. We specialize in:

  • Health insurance carriers
  • Personal injury protection (PIP) carriers
  • Self-insured payers
  • Worker’s compensation carriers
  • Third-party administrators, MERPs
  • International payers
  • Complex claims payers