Save - Claim Negotiation & Signoff (CNS)

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Claim Negotiation & Signoff (CNS) 

When paying for healthcare, consumers should have the right to secure fair rates without the threat of balance billing. Utilizing a comprehensive program combining targeted data, industry expertise, and negotiation by attorneys, our clients enjoy true savings and protection through provider signed agreements.

CNS can be used to negotiate any non-contracted bill for medical services, regardless of whether the effort is being made on behalf of a health plan, administrator, or carrier.  What’s more, the service becomes a necessity when a plan finds itself in the final stages of liquidation.  Liquidation of a health benefit plan is an unfortunate and complicated event for all parties involved.  Fortunately, The Phia Group can help by handling all forms of resultant claim settlements, including complicated multi-claim and multi-employer scenarios. The Phia Group applies its years of experience to reduce costs and administrative burden associated with such claims. The Phia Group informs the relevant provider community of the situation, while promoting settlement as a fair and efficient way to resolve outstanding balances. The Phia Group’s proprietary process ensures that the impact of available monies is maximized, seeking to settle as many open claims as possible, and protecting families impacted by the liquidation against financial hardship.  Lastly, The Phia Group confirms that the methods applied and accompanying documentation harmonize with all requirements, including but not limited to applicable proof of claim processes. 

 

Overpayment Recovery

With The Phia Group’s Overpayment Recovery service, its recovery specialists investigate and recover funds that were overpaid, irrespective of the cause. This service entails a comprehensive review of plan language, claim details, and supporting documents at implementation as well as plan document enhancements to optimize recovery results.

The Phia Group takes pride in tailoring recovery strategies for all plan types based on particular legal venues and case types. Along with offering extensive reporting with custom-tailored parameters, The Phia Group has the legal expertise necessary for countering the most complex overpayment scenarios and the ability to cross reference and bundle claims for facilities and providers regardless of size.

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The Data

The Phia Group taps into our comprehensive data to define equitable, market-based prices for medical care. The Phia Group places payers on a level playing field with the providers – maximizing savings. Many providers use comparative data when, for instance, making their implant purchases. We leverage this data to provide a foundation for effective negotiation.

The Negotiators

A cost containment program is only as good as the people executing it. The Phia Group’s legal expertise combined with objective cost data yields enforceable savings.

True Savings

The Phia Group’s fee is based upon actual savings achieved compared to fictional savings derived by applying a percentage to egregious and arbitrary charges. At last, the industry can rely upon reasonable fees applied to only true savings, thereby achieving actual cost-containment.