August 8, 2011

Success Story - Claim Negotiation Success

When considering a TPA, you’re ultimately looking for a company that can process claims. The Unified Advantage provides a much more thorough approach when administering employer’s benefit plans. For example, our claims negotiations provide exceptional savings for our customers.

  • A patient had a defibrillator implanted and the facility billed $337,775.96 – Unified negotiated a discount and the facility settled for $90,000.
  • A patient had outpatient surgery at an out of network facility with $2,596.05 in charges, and a 25% discount was obtained. The facility billed $26,297 in late charges. Our agreement indicated that no late charges would be billed – $26,207 was written off.
  • A patient had surgery at a teaching hospital and the provider billed for assistant surgeon who was a resident – these charges were written off.
  • A surgeon billed $29,490 with a PPO discount of $18,000 – the provider settled for $5,000.

These are just a few of the Unified client success stories, and it’s just another one of the many advantages of utilizing Unified for your Third Party Administration. Unified maintains an average turnaround time of five business days while also looking out for opportunities to negotiate discounts for our customers and it’s all included in our base administration fee.

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