Out-of-network claims are an expensive reality for all health care plans. ACM out-of-network claims negotiation utilizes multiple strategies in mitigating your costs for those situations where a claim falls outside of your primary network.

Direct Negotiation

ACM personnel have over 30 years of executive level provider contracting experience that enables us to successfully negotiate individual discounts for out-of-network claims. ACM clients typically receive discounts from 10-40% as a result of our efforts.

PPO Relationships

ACM has contracted with nationally recognized PPOs for use by our clients when an out-of-network claim occurs. Through these relationships, our clients receive:

• Access to PPO discounts with over 700,000 providers nationwide including hospitals, physicians and ancillary services
• Streamlined repricing process typically within 24 hours
• Average discounts of 15-25%
• No minimum dollar threshold for claims to be repriced

The Bottom Line

By utilizing ACM for your out-of-network negotiations, multiple negotiation strategies will be utilized minimizing the financial impact of claims that fall outside of your primary network.