Compmed Advantage - Non-Network Negotiation

NON-NETWORK NEGOTIATION

Out-of-Network Discounts

The CompMed Partnership Network will impact the majority of clients bills, however, CompMed Partnership offers a program, which applies to non-network bills, that combines automation, negotiation and clinical staff to obtain the maximum possible savings on non-network bills. Thresholds and bill type may vary by client, based on bill severity.

The automation of the program allows the CompMed Partnership to capture all billing history for an individual provider and allows negotiators access to a wide variety of data to maximize savings. We also partner with another cost containment company to offer additional out of network negotiation services. Our collective efforts for the Non-Network Negotiation Program yield an average savings of 16%, with savings from our business partner’s program averaging 60%.

The CompMed Partnership uses three strategies negotiating non-network discounts:

Negotiation with providers based on current bill details and prior negotiation history.
Review of charges for accuracy.
Appropriate market pricing.

When a client implements the non-network product, edits are set to recognize dollar thresholds and bill types that qualify certain bills for the program. These edits automatically identify bills for negotiation based on the predefined thresholds. The bills are then routed to our negotiators, who then review the bill using a proprietary bill audit screen. The proprietary application used by the negotiators allows for easy tracking and reporting of bills identified for negotiation. Provider and client history, along with market pricing information, is also reviewed to achieve the best possible savings on the bill. Following the negotiation and completion of the settlement agreement with the provider, the bill is submitted and finalized within the proprietary bill review system.

Providers rely on timely payments as incentive to finalize a negotiation. Negotiated agreements offer reimbursement to the provider within 10–14 business days from the signature date on the agreement.

In addition to our negotiation program, we partner with another cost containment company to offer the following additional non-network services: