In-network and out-of-network medical bills can be repriced on the
Internet using any computer, anywhere, with any Internet access. It's
FAST and EASY!
CAI has a four-tiered approach to achieving the greatest savings
possible:
- If CAI is providing Primary PPO management services for your
company and the claim is in-network, RepriceNow immediately
reprices the claim*.
- If the claim is out-of-area for a traveling employee or covered
dependent, and you are accessing our Travel Network, you can receive
immediate in-network savings through RepriceNow.
- If the claim is out-of-network, RepriceNow enables you
to reprice the claim through a Wrap PPO or Supplemental PPO, and
provides immediate results.
- If a claim cannot be repriced through a PPO, you can submit the
claim through RepriceNow for negotiations, regardless of the
claim amount.
* Clean claims repriced through a PPO loaded in our system are returned
within seconds of submitting the claim. Complicated claims or claims
meeting our QA requirements may require one additional
business day for repricing. Negotiated claims
are returned within the time frame specified by you at implementation.
For companies with a high volume of claims to be repriced, CAI can connect
with a client electronically to quickly and efficiently transport claims for
repricing and back for automated adjudication. To support your move to EDI, CAI:
- Maintains a team dedicated to EDI implementation and support efforts
- Supports multiple formats, including proprietary formats and industry standard ANSI X12
- Facilitates multiple data security and data transmission capabilities, including encryption, Secure FTP, and VPN
- Integrated with a growing list of the major claim adjudication systems
If you are not currently capable of EDI, CAI can provide format specifications and
assistance with data retrieval design to move you to EDI capability with minimal
resource commitments. An EDI connection with CAI is typically accomplished in a
matter of weeks. One of the great benefits to electronically connecting with CAI
is that through this single connection you also gain access to additional PPO repricers
enhancing efficiencies and reducing administrative costs.
RESULT: A Streamlined technology solution that fits your needs
today AND tomorrow.