Out of Network Solutions
Mitchell provides a wide array of negotiation solutions to insurance carriers, Third-Party Administrators, self-administered employers, and injury claims professionals that result in successful healthcare cost containment. For more than two decades, our clients have realized hundreds of millions of dollars in benefit opportunity for their policyholder customers involved in injury claims.
The combination of established provider relationships by Out of Network Solutions and Specialty Bill Review over the past two decades provides a unique opportunity to deliver negotiated settlements between Out of Network medical services providers and payers, for both small and large bill amounts. Managing medical costs via negotiated settlements can effectively extend a policyholder’s limits, helping to increase customer satisfaction.
A New Era in Cost Containment Solutions
With the recent acquisition of Specialty Bill Review, Mitchell enters a new era in cost containment solutions. We are able to leverage Mitchell Out of Network Services’s provider data, consisting of two decades of history and positive relationships, and combine these assets with Specialty Bill Review’s Knowledgeable Provider Negotiation® (KPN) product which leverages Specialty Bill Review data. The combination of best in class Out of Network products and operating models will allow us to empower better negotiation outcomes (i.e., higher yields), and allow us to deliver negotiation services under one umbrella and one system.
An additional new service is Square One Solutions, which provides negotiation solutions for a pre-approved medical treatment. Square One Solutions is a prospective or concurrent negotiation solution for securing savings on any pre-approved inpatient facility stay, such as surgical procedures, inpatient rehabilitation, long-term care or any extended care stay.
Through this powerful combination of services, we are able to use our fully combined data assets to deliver data driven, results based PPO/OON tiering. The result is optimization via highest yield solution positioning to empower better outcomes.
Benefits for Clients
- Best in class products drive even better outcomes as combined solution
- Combined solutions drive Mitchell’s commitment to improve year-over-year outcomes
- Data analytics and product innovation capabilities ensure sustainable results with great service
- Prompt pay is the standard that provides measurably better outcomes
- Providers more willing to negotiate for date certain payment
- Harmonious – long standing relationships with all provider types
Learn about the 5 critical tools you will need in order to develop an Out of Network negotiated settlement strategy that can help you maximize medical cost savings.
February 26, 2013
Mitchell releases predictions for trends related to cloud computing and big data analytics that could affect the insurance industry throughout 2013
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November 27, 2012
Though claimants often have a choice when it comes to medical providers, charges for treating with out-of-network providers can be substantially higher than charges submitted by doctors in preferred provider networks…
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