Care Empowered Pricing™ –
A Revolutionary
Reference-Based Pricing Solution
Find Quality Care and Fair Pricing YOUR WAY
Joined The Phia Group in 2012
A New Way to RBP
Building on our industry-renowned Balance Bill Resolution and compliance services, we now empower TPAs with technology-enabled provider selection and access support.
Phia Ignite Repricing Engine Technology
Phia is not a pricing strategy organization. Instead, we serve as an execution engine—implementing the reimbursement methodologies defined by TPAs and plan sponsors. Whether those methodologies are based on Medicare benchmarks, usual and customary rates, or other standards, Phia calculates, supports, and defends those determinations through expert negotiation and documentation.
Our Technology
Our Support
Your Program
Provider Data and Selection Technology
Balance Bill Resolution
Your Market
Benchmarking
Independent Legal Representation
Your Methodology
All-Encompassing Data
Plan Defense and Advocacy
Your Clients
Provider Quality Metrics
Renowned Compliance Service
Done Your Way
It’s Time to Own Your Reference-Based Pricing Program Instead of Administering Someone Else’s
Better
Savings
or Less Balance
Billing
Years of RBP
Partnership Success
The Phia Group’s Balance Bill Savings in Action
A client approached Phia with a balance bill issue totaling nearly $300,000 across 80 claim lines. Given the substantial amount, Phia’s first priority was to ensure all details were aligned. However, the client emphasized that a swift resolution was critical.
Balance Bill Resolution
Leveraging more than a decade of experience, we provide Balance Bill Resolution at no additional cost. Our Balance Bill Resolution service is unparalleled throughout the country as it features direct intervention and independent legal support to prevent unexpected financial burdens on employees and reduce the administrative load on employers and TPAs.
With Balance Bill Resolution accounting for regulatory compliance, costs, financial benchmarks, quality, severity, and other factors, your risks are mitigated amidst the evolving regulatory landscape of the No Surprises Act (NSA), including the Open Negotiations and Independent Dispute Resolution (IDR) processes.
No Surprises Act Support & Independent Dispute Resolution Services
No Surprises Act Support
The Phia Group’s NSA service is available to users of both Unwrapped and Balance Bill Resolution, and includes support for payment and open negotiations, as well as formal dispute resolution triage and navigation. With years of experience in balance bill resolution, litigation, and nationwide negotiations, we provide NSA payment analysis and recommendations including an initial payment, QPA support, and multiple factors to utilize in open negotiations.
Independent Dispute Resolution Service
With our extensive team of staff attorneys, clinical auditors, certified coders, and data analysts, The Phia Group supports you in efficiently strategizing and responding to the unique standards for cost containment and defense set by the NSA. The Phia Group provides:
Timeline
tracking
Procedural challenges and orientation support
Guidance leading up to and throughout the entire process
Bill Hoitt
Director of Sales
Crum & Forster
“It’s rare to have a team built like The Phia Group that can handle something from every avenue of the healthcare industry from plan documents to claims negotiations to member services and everything in between.”
Ken Uveges
Owner
Enterprise Group Planning, Inc.
"We have been partners with The Phia Group for Care Empowered Pricing for many years and they are excellent at all facets of their reference-based pricing platform. Phia is an excellent source for analytical data which empowers us to make important decisions in directing care and negotiating reimbursement rates. Most importantly, they support our program including our direct provider contract relationships and don’t try to push themselves into my market with pressure sales and short-term gains. Phia is a true partner for us."
What You Can Expect with The Phia Group
Innovative, industry-leading plan language that flawlessly supports the program.
Plan defense and advocacy with CARE at the center of everything we do.
Balance bill prevention with professional negotiations and provider sign-off.
You define documented and defensible payments integrated with our custom dispute resolution software.
The Phia Group is the industry’s most trusted partner for front-end plan design, setting the standard for cost containment services—now we’ve set the standard for reference-based pricing with our Care Empowered Pricing program.
Member Education
Access Support
Selection Technology
High-Quality & Justifiably Priced Care
Want to Learn More About What Our Other Services Can Do For You?
The Phia Ecosystem
Our services work together—or individually—to help you recognize your full cost containment potential.
When Plans Win, So Do Families
We believe that everyone should have access to high-quality and justifiably priced care.
Contact us today to get started.
