Achieve Deeper Savings Through a QPA-First Strategy
NSA is a consumer protection law that was designed to relieve the burden of unexpected billing, ensuring that patients are informed and aware of any medical bills from out-of-network providers. To streamline this process, partnering with providers in out-of-network claim agreements can be beneficial but leaves space for deeper savings.
Reliant frequently receives inquiries regarding our NSA process and our payment calculations - both essential components of our overall strategy.
QPA-First Strategy
At Reliant, we continue to maintain an extensive amount of direct out-of-network agreements with providers nationwide, referred to as Continuous Discount Agreements (CDAs). These agreements refresh each year and are leveraged to deliver deep discounts that eliminates appeal risk altogether. Clients that are confident in using Reliant for QPA or initial payment pricing under NSA or state-regulated requirements see only 10% of claims using CDAs.
How do we achieve deeper savings?
By adopting a “QPA-first” approach that reflects our strict adherence to regulatory guidance and our extensive experience with defensibility, we achieve deeper discounts, averaging 65% of billed charges.
With our NSA pricing process, we remain dedicated to total transparency and fairness. Reliant leverages our detailed QPA calculator that uses proprietary logic for adhering to complex and evolving regulatory rules. Using multiple data sources, every nuance of the NSA or applicable state balance billing law is used to precisely calculate QPAs and initial payments.
Strengthen Your Outcomes
Reliant understands that reducing appeal volume and costs are key goals for most payers. Increasing cost and operational burdens are often associated with larger scale disputes. With our extensive industry expertise in current NSA statues and regulations, we have crafted a refined approach designed to balance maximum defensibility, minimal provider abrasion, and strong financial outcomes. With our data-driven post-payment strategy, we assist organizations in navigating the complexities of NSA compliance with ease and confidence.