ZanexMed’s expert negotiators specialize in recovering underpaid Out-of-Network Claim Negotiation for hospitals and emergency facilities. Out-of-network billing is notoriously complex and often involves third-party repricing vendors – in fact, MultiPlan (now Claritev) processes over 80% of such claims. By combining our decades of revenue cycle experience with advanced analytics, we secure the best possible reimbursement for our clients. Industry data shows that dedicated negotiation teams can achieve major savings: one provider reports an average of 60+% savings from negotiated claims. ZanexMed applies this expertise to every claim, ensuring no dollar is left on the table.
Our Negotiation Settlement Team
ZanexMed’s negotiation settlement team has extensive billing and coding expertise. We manage the entire negotiation process with insurers and their repricing vendors on your behalf. These vendors often use complex algorithms and employer benefit limits to suppress payouts, but our team knows their tactics and terminology inside and out. Over years of experience, we’ve built a proprietary OON database and know-how, enabling us to identify underpaid claims quickly and challenge any low offers. By handling these complex appeals, ZanexMed lets providers focus on patient care instead of paperwork.
Our Process: Pre-Payment and Post-Payment Negotiations
ZanexMed negotiates every eligible claim through both stages of review:
- Pre-Payment Negotiation: We review settlement offers that insurers send via negotiation to vendors before paying the claim. By accepting or countering these offers, we often secure higher reimbursement right away.
- Post-Payment Negotiation: If an out-of-network claim was already paid at a low rate (based on repricer pricing), we reopen and appeal the claim. Our team uses detailed data and policy expertise to dispute the underpayment and pursue additional payment.
This dual approach means no claim goes unexamined. Whether insurers try to push a low up-front settlement or hide behind back-end repricing rules, ZanexMed fights for full, fair payment. Our clients gain peace of mind knowing their revenue is maximized and their patients are protected from surprise costs.
Why Choose ZanexMed
With over a decade of experience in revenue cycle management, ZanexMed is recognized for delivering results in Out-of-Network Claim Negotiation billing. Our strengths include:
- Deep Expertise: Skilled billers and coders experienced with hospitals and emergency services.
- Data-Driven Strategy: Proprietary OON data and analytics guide our negotiations.
- Proven Results: Millions recovered in underpaid claims for providers.
- Patient-First Philosophy: We strive to minimize patient debt and improve satisfaction by lowering surprise bills.
Partnering with ZanexMed means trusting a team that tirelessly advocates for your practice’s financial health. We stay up-to-date on regulations (like the No Surprises Act) and continuously adapt our techniques so you always get maximum reimbursement without the hassle. Contact ZanexMed today to ensure your out-of-network claims are negotiated accurately and profitably.