Group Health Claims Repricing
The Smart Savings Solution You’ve Been Waiting For
Enjoy the safety of a network, without the strings – and with much deeper discounts.
Group Health Overview
More Savings, Better Access, Less Hassle
Consistently capture deep health plan savings, with the Reliant model for medical claim repricing. From single-case specialty pricing, provider contracting, and Direct to Employer (DTE) programs, to Safe Harbor arrangements, Reference-Based Pricing (RPB), and open-access health plans – we tailor each service to employer and member needs.
Group Health Services
Deep Savings + Streamlined Experience
Unlock better savings and a better experience than with a Preferred Provider Organization (PPO), plus reduce the access and appeals issues you’d get with Reference-Based Pricing (RBP). Because we’re not a network, members aren’t tied down to particular providers – they can go wherever they want to get the care they need. All with much less healthcare spend and administrative work for employers. Tap Reliant first, and see how much more we can save you on:
Specialty claims
“Reliant has been a great arrow in our quiver for winning new business. They are a fantastic alternative to other, more disruptive re-pricing solutions. Reliant has made all the difference for many of our groups. Our customers see the value Reliant delivers over the long-term.”
– Donn Duhon, Vice President of Business Development, Employee Plans
The Process
Balanced Strategies for Dependable Results
The Reliant model goes further than anyone else does, to get results no one else can. Our Fair Market Pricing approach is the next generation methodology that leverages dynamic, real-world data points - not just a single Medicare reference point. This ensures not just the deepest discount possible, but a defensible price that gets accepted over 99% of the time. Each claim we receive gets:
Charge verification for accuracy and appropriateness
Multidimensional data benchmarking
Fair price determination
Detailed Explanation of Review (EOR)
Turnaround in 48 hours or less, guaranteed
Support
Full-Service Advocacy and Management
Your Human Resources department definitely doesn’t have time to manage access problems, appeals, balance billing, and health plan reporting. We cover it all to make members’ and employers’ lives a little easier:
Dedicated member access advocacy
Full appeals and balance billing management
Single-case agreement negotiation
Narrow network development and management
Robust monthly, quarterly, and annual reporting
Next Steps
Experience Savings without Strings
Get started with a free consultation and custom savings analysis. What could you do with deeper health plan savings, and a great member and employer experience?