Fee Negotiation
It’s impossible for any network, to have every provider contracted at a discount. For that reason, IHP created an out-of-network claim negotiation program. IHP’s skilled negotiators, who have backgrounds in areas such as claims adjudication, hospital administration, and law, contact providers and negotiate deep discounts in return for prompt payment. Our team utilizes various tools during the negotiation process, including U&C pricing publications, Medicare tables, and proprietary pricing databases. All negotiations are finalized with a written agreement outlining the terms and preventing the provider from balance billing the patient. The end results are deep discounts and success in achieving savings on more than 80% of the dollars referred for negotiation.

Medical Claim Review
Inflated and inaccurate charges may prevent payors from realizing the maximum benefit of their PPO relationship. A Medical Claim Review can be a great tool to use both alongside your PPO discount, and for claims that fall outside of the network. IHP’s Medical Claim Review program includes a wide variety of cost containment solutions that are designed to be used for in-network claims, out-of-network claims, or both. Through the use of nationally recognized and defensible billing and coding standards, IHP identifies unreasonably high charges, billing errors, erroneous charges, and unbundling practices through an invasive line-item hospital claim and/or medical record analysis. Reports are then submitted to IHP clients who in turn submit the findings to the provider. Our clients have saved an average of 35% off of billed charges through the use of our various audit solutions.