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SERVICES:Secondary Networks   Disease Management   Fraud, Waste, & Abuse   Repricing Technology
SERVICES:Reporting   Workers’ Compensation   Customer Service  
 
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Workers' Compensation

Coalition America, Inc. (CAI) has developed a unique program to generate significant savings on workers' compensation medical bills. Our strategy is simple - utilize a three-tiered approach to secure the greatest savings possible.

First Tier: Supplemental PPO Savings

  • Access to multiple PPOs in each state (typically 3-5)
  • Contracts with PPOs allow CAI to discount medical bills below the state fee schedule, UCR or billed charges as appropriate
  • Enhanced savings by ranking PPOs based on historical savings in each state
  • Instant access to discounts through RepriceNow (Internet repricing solution)

Second Tier: Continuous Discount Agreement (CDAs) Savings

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

Third Tier: Direct Negotiations

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

What's in it for you?

  • Reduction of provider fees below state fee schedules, UCR, or billed charges (as appropriate)
  • Market advantage by enabling your clients to achieve additional savings
  • Immediate discounting results through RepriceNow (Internet repricing)
  • Increased business through favorable premiums as a result of lower medical loss ratios
  • Lower administrative costs through a reduction in undiscounted bills
  • Discounts backed by direct contracts with every PPO and negotiated provider
  • Employer-specific reporting as well as aggregate reporting
  • Increased revenue
 
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