Insurers, TPAs,
& Corporate Payers

Results Delivered.


Save 35% or more on most out-of-network claims


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


100% of negotiation evidenced with signed agreements to lock in savings


Zero arbitration record on settled agreements

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.
  • Drop-in networks often sub-optimize savings for ease of application.
  • You may be optimizing speed but sacrificing savings and stakeholder value.

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.

We will create a negotiation competency for your firm.


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

Recommended Services

Payer Claim Negotiation

Prospective Negotiation

U.S. Medical Tourism