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Non-network claim options
You’ll save the most when you combine non-network claims management with our network options. We offer flexible solutions to meet your non-network claim needs such as:
- Large Claim Review. High dollar hospital claims are audited for billing and coding accuracy
- Single claim negotiation of non-network claims
- Medicare-based repricing. An alternative to traditional methods of repricing non-network claims. Claims that are non-participating with the PPO network are repriced at a percentage of the Medicare allowable for each service. Where there is no Medicare allowable for a service, we can apply pricing from an alternate reference-based pricing schedule.
- Supplemental networks – You get additional savings for claims that fall out of First Health’s networks with our supplemental networks. These consist of regional, local and specialty networks. No additional logo on the ID card is needed.
Contact us to learn more about our non-network claim options.