SERVICES: Questionable Providers   Claim Editing   Primary Networks   Network Management
SERVICES:Secondary Networks   Disease Management   Fraud, Waste, & Abuse   Repricing Technology
SERVICES:Reporting   Workers’ Compensation   Customer Service  
 
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Out-of-Network Repricing Services

CAI offers a unique four-tiered approach to discounting out-of-network claims. Clients can choose all or select services to meet their needs

Wrap PPO Savings

  • Access to key providers nationwide
  • Requires logos on ID cards
  • Increased savings through deeper discounts

Supplemental PPO Savings

  • Access to multiple PPOs in every state (typically 5-15)
  • Enhanced savings by ranking PPOs based on historical savings in each state
  • Contracts with PPOs allow CAI to access discounts without patient steerage
  • Instant access to discounts through RepriceNow (Internet) solutions
  • 24 hour turnaround when repricing EDI claims
  • No logos or patient steerage necessary
  • No balance billing

Continuous Discount Agreement (CDA) Savings

  • Pre-established discounts with over 35,000 providers
  • Immediate repricing results
  • New CDAs added weekly

Provider Negotiations

  • Additional claims discounted through direct negotiations on ALL size bills
  • Deeper discounts by grouping specific provider bills for leverage
  • Client specific turnaround time to meet your needs
  • Access to thorough claims review and evaluation

RESULT: Greater overall savings through deeper discounts on more medical bills.
 
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