Claims
Repricing

Maximizes Primary Network
Access & Discounts

Effective PPO network assignments and Medicare referenced reimbursement rates, simplified claims routing and integrity based negotiations equal the greatest opportunity for savings.

Hand Shake

What’s Inside the Box

Savings Optimization

  • "Best fit" networks are chosen based upon location, historical claims experience and analysis of multiple networks
  • Network selection is determined at the member level and where care is actually being received
  • Individual network assignment allows for multiple primary and wrap networks to be best utilized by the group

PPO Results

Network Savings Graph Network Savings Graph

*Actual results from 10K employee group

PAR3 Fair Pay Referenced Reimbursement Rates (offered as a Primary Network or as a U&C alternative for OON Claims)

Our Process

  • Contact and Contract

    With individual networks as identified for primary, wrap and supplemental access

    Contact and Contract
  • Maintain

    All network agreements

    Maintain
  • Provide

    Single source claim routing to unlimited networks for discounting

    Provide
  • Handle

    All customer service issues including provider inquiries

    Handle
  • Deliver

    Repriced claims to payer via daily EDI exchange

    Deliver

The INETICO Advantage

  • Guaranteed 100% provider sign-off on all INETICO negotiations = no patient balance billing
  • Competitive return for the payer includes reduced claim turn-around-time, expanded frequency of EDI connectivity, and efficiencies of scale due to volumes with networks
  • Primary and wrap network assignment based on geographic location and member utilization results in highly effective claim cost containment at the member level
  • Access to limitless national, regional and local networks with no minimum participation requirement
  • Provides effective options to compete against large PPO networks, or alternatives to traditional PPO models altogether
  • Simplified single source claim routing to unlimited networks

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