What Property and Casualty Payors Need to Know About Out-of-Network Solutions

In the property and casualty world, out-of-network medical bills represent a large portion of all new bills — over 50% in some states. So, property and casualty payors must take care in choosing an out-of-network solution. In this post, we list our top five considerations when choosing an out-of-network solution for your workers’ compensation or auto medical bills.

Tackling Out-of-Network Medical Bills with Data iSight

To tackle the problem of out-of-network charges, Claritev developed our Data iSight pricing methodology. Unlike Usual and Customary (U&C) or Medicare-based repricing solutions, our methodology recommends reductions using both a cost-up approach (for facility claims) and median reimbursement levels (for practitioner claims) to achieve maximum defensibility, wide provider acceptance, and savings of 61%-81% off billed charges.

Six Common Questions About Reference-Based Pricing Answered

The beginning of the COVID-19 pandemic in 2020 gave rise to a new way in which payors, providers, employers, and employees look at healthcare. New questions emerged regarding the affordability of provider services, equality of access to healthcare services, and the overall model of how employers can offset organizational healthcare costs while ensuring affordable healthcare for their employees.