Next Level Medical Billing Out-of-Network Negotiation Services
Negotiating out-of-network claims is a crucial element of out-of-network billing, especially for hospitals and freestanding emergency rooms. At Next Level Medical Billing, our negotiation settlement team brings decades of experience in medical billing, coding, and revenue cycle management, with a focus on hospitals and freestanding emergency facilities.
Having Next Level Medical Billing’s skilled negotiators handle your out-of-network negotiation settlements and underpayment appeals can provide significant advantages. Navigating the complexities of insurance companies and their tactics, which often obscure reimbursement opportunities, can be challenging. Our expertise ensures that you receive the maximum possible reimbursements, even with the limitations imposed by benefits policies.
Our out of network negotiation settlement team will utilize their expertise and OON database to negotiate on your underpaid claims with insurance companies and negotiation vendors i.e. Multiplan, Viant, Zelis etc. on your behalf. We know their terminology and we know all the tricks of negotiating the best rates for our clients. Out-of-network billing is the trickiest aspect of billing, and we are well-known in this industry as the experts in the field.
We protect your patients by carefully analyzing historical data based on your locality and negotiate based on the analysis. Right Medical Billing ensures that we negotiate each claim, on your behalf, as well as your patients, so that they are not stuck with a massive out-of-pocket expense.
We’ve been navigating these insurance companies and negotiation vendors for more than 10 years on pre-payment and post-payment negotiations which helped us to create our own OON database which we utilize to identify underpaid claims. We know that Insurance companies utilizes employer preferences and limitations in determining reimbursement on your medical claims but still our negotiation settlement team knows how to identify limited benefit policies and employer preferences which help us to negotiate your bills on maximum re-pricing.
Pre-Payment
Settlement offers are received from negotiation vendors on behalf of insurance companies before claim reimbursement.
Post-Payment
The claim is reimbursed by the insurance company based on the pricing provided by the negotiation/pricing vendor, and the claim is reopened for renegotiation.