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
Payer Claim Negotiation