With Phia Unwrapped, The Phia Group replaces wrap network access and modifies non-network payment methodologies, securing payable amounts that are unbeatably low, based upon fair market parameters. Wrap, extender, and other leased networks offer small discounts and audit restrictions, affording medical service providers nearly unlimited rights. Meanwhile, “out-of-network” claims are paid at seemingly arbitrary levels, in addition to the resultant balance billing of patients. Phia Unwrapped replaces both, and places no minimum threshold on claims to be repriced or potential balance billing to be negotiated. Wraps are eliminated and non-contracted claims are priced using defensible metrics. Balance bill disputes, if any, are resolved without impacting participants. At the time of payment, we attempt to secure preemptive sign-off, ensuring providers will accept the plan’s payment as payment in full. If that effort should fail, the industry’s best team of negotiators are on the case.
In order to bolster Phia Unwrapped, Phia’s team of certified medical coders, clinical staff, and attorneys have coalesced their integral resources – price transparency data, benchmarking, Artificial Intelligence, provider quality metrics, and other proprietary methodologies – into Phia Ignite Repricing Engine. Subsequently, we are able to ensure that defensible claims payments are consistently calculated with pinpoint accuracy, thus reducing unnecessary risks while maximizing savings for our valued clients.
Phia Unwrapped Provides:
- Innovative Industry-Leading Plan Language that Flawlessly Supports the Program
- Replace Unfavorable Wrap Networks & Ambiguous “Out-of-Network” Pricing
- “Unwrap” all “Out-of-Network” Claims, with No Minimum Dollar Threshold
- Prevent Balance Billing with Professional Negotiation and Provider Sign-Off
- A Fee Based on a Percentage of Actual Savings Means Fair Rates and No Excessive Cost – We Don’t Get Paid Unless the Savings Are Permanent!