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Moving away from the “Out of Network” name

—October 17, 2016
Moving away from the “Out of Network” name

Introducing SmartPrice™ Solutions

By Greg Gaughan Vice President and General Manager SmartPrice™ Solutions Mitchell Casualty Solutions Group

Historically, cost containment products have been developed in boxes – solutions were either for in-network or out of network bills. But now, that model is starting to change. What was once known as the “out of network” space doesn’t seem to exist anymore in workers’ compensation and auto casualty claims. Mitchell has seen this change happening fast in the industry, which is why we’ve decided to let go of the “out of network” name to describe our special cost containment solutions.

We are pleased to announce the new SmartPrice™ Solutions, which more accurately describes the services we offer and matches what is happening in the market. Mitchell’s SmartPrice Solutions, which includes negotiations, market value pricing and charge validation analysis, use a combination of experts, data and software to help your company achieve the fairest price on all of your bills. The negotiations product applies to auto casualty and workers’ compensation claims, while the market value pricing and charge validation analysis products apply only to workers’ compensation claims.

Our new name is intended to help industry professionals see the cost containment world differently and understand that the old model is limiting to a payor’s success — many times what were traditionally considered “out of network” solutions are actually performing much better on a variety of bill types than traditional networks in some states.

We are already seeing some payors shift out of that mindset and start thinking instead, “What are the top five cost containment solutions I should be using?” Those payors have seen major improvements from simply optimizing their workflows by putting their solutions in the best position in their stack based on performance instead of relying on historical placements. In fact, just by optimizing solutions that are already in use, payors may be able to realize a 30-50 percent improvement in cost containment in certain states.

Click here or contact your Mitchell account manager to get more information about this trend and to learn how Mitchell can help optimize all of your cost containment solutions for the best results.


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