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Solutions

MultiPlan is the industry's most comprehensive provider of healthcare cost management solutions. We deliver more options, innovation and value for today's healthcare payers and providers seeking a strategic response to the evolving managed care landscape. Tightly integrated and designed to work in combination with each other, our solutions deliver a single electronic gateway to a comprehensive set of claim cost management solutions that help control the financial risks associated with medical bills while helping providers more effectively control reimbursements.

When our full solution suite is used, each electronic claim is compared against our cost savings mechanisms in a specific order, consistent with the requirements of our contracts and the relevant benefit plan. This results in predictable savings and maximum patient and provider satisfaction. It also avoids errors and delays that often result when claims are routed from vendor to vendor:

  • Step 1: Reprice through the primary PPO network
  • Step 2: If the provider does not participate in the Primary PPO, reprice through the complementary network
  • Step 3: If the provider does not participate in the complementary network, take one or both of two powerful out-of-network cost reduction measures:
    • Negotiate a reduction directly with the provider, or
    • Apply a defensible reduction based on actual facility costs and median practitioner reimbursement levels

For additional savings on transplants, MultiPlan also offers a nationwide Centers of Excellence network.