Services: Cost Management
MedSave's innovative cost management model is comprised of the following:
- Claims utilization and savings results monitored regularly through proprietary algorithms
- Contracts & processes continually adjusted to enhance savings performance
- Established relationships with International Departments of leading health care institutions
- Secure discounts contractually, delivering ensured savings that last
- Leveraged technology to maximize efficiency in operations
- Maintaining a high degree of visibility, communication and transparency with all business partners
Based upon these principles, we apply three distinct processes to obtain significant discounts on medical bills: Financial Case Management, Direct Negotiation and Claim Repricing.
Case Management • Direct Negotiation • Claim Repricing
Case Management
MedSave's Case Management team ensures that client cases are reviewed and managed by a team of professionals dedicated to optimizing healthcare services and maximizing client discounts. Case managers maintain regular communication with clients to offer financial disposition and progress for each case.
Each case is reviewed and documented in MedSave's HIPAA-compliant claims system. MedSave's proprietary cost management practices are then applied to the charges. The case manager verifies each cost, facilitates payment to the provider, and records the patient history and the claim.
Direct Negotiation
MedSave's history as a forerunner in the healthcare management industry has enabled the company to establish and cultivate strategic relationships with thousands of providers worldwide. These relationships serve as the foundation–and the impetus–for hundreds of other providers added each year by MedSave's Direct Negotiation team.
Upon claim submission, our Direct Negotiation team screens each claim for applicable criteria. The Negotiation team members then access MedSave's proprietary provider database to track charges and discount history. The team advances funding of each claim to achieve the best discount, and then issues a Release and Waiver Agreement to secure negotiated discounts and to eliminate the possibility of balance billing and to close the case.
Claim Repricing
Using an automated computer system with highly secure access, MedSave's Claim Repricing process finalizes financial Case Management and Direct Negotiation Claims, and is also utilized for all other in-network claims.
We are proud to boast our relationship with the most prestigious HMO in the United States and additional national PPO's. We have access to over 750,000 providers and 5,000+ hospitals where we obtain discounts for our clients.
Once claims are received by MedSave's team of adjusters, the data is screened for accuracy. A discount is then achieved through PPO Networks or Direct Negotiation/Agreement. A repricing notice is issued to the client, and payment is processed according to eligibility and plan benefits. Turnaround for this process averages about four days.
MedSave's specialized claims reporting and database system enhances efficiency, accuracy and flexibility, for faster claims adjudication.