Silent PPO Service

Payers pay millions in fees annually to organizations that specialize in lowering hospital reimbursements from non-contracted healthcare services. Hospitals currently respond in a retrospective fashion creating the opportunity for payers to utilize aggressive discount shopping. NHPN reengineers the retrospective process to a prospective solution allowing the hospital to eliminate unauthorized claims re-pricing and aggressive fee negotiations.

Our prospective Silent PPO Service prevents payment abuse from occurring and ensures prompt and accurate reimbursement.

• Review daily admission reports and verify “non-contracted” status. Identify and report mis-registered top tier claims to hospital
• Research and prepare “non-contracted” accounts for proper billing by hospital
• Commence follow-up, negotiation and collection actions
• Track habitual discount abuse and methods to combat their tactics
• Recommend contract language to eliminate loopholes in managed care contracts

In addition our retrospective Silent PPO Service audits zero-balance accounts to identify and recover improper discounts.