Out of Network Negotiations

Bill negotiations reduce the costs of medical bills from providers and facilities that do not participate with a provider network for total cost management.

Our negotiation team proceeds with a review of UCR, Medicare, claims utilization history and in-network payment rates to aggressively negotiate with non-network hospitals, physicians, and ancillary health care providers to reduce costs.

Medlogix’s Bill Negotiation program includes:

Direct negotiations by experienced, highly-skilled negotiators with expertise and knowledge of rate levels
All negotiations are confirmed with signed Letters of Agreement from providers
Prospective and retrospective negotiations
Customized referral criteria
First and Third party Auto negotiations include signed Letters of Acceptance (LOAs) for each negotiated PIP bill.

Front view of diverse medical team working together at table in hospital. Coffee cup, glass of water, clipboard, medical folders, and laptop are on the table.

Provider bills are Processed

Less than

0%

appeal rate

Reflecting our highly accurate repricing and contract application

0%

of bills negotiated

Letter of Acceptance obtained

FREQUENTLY ASKED QUESTIONS

Does Medlogix offer national PPO access?

More Local Information

CHN PPO | Bill Negotiations

CHN PPO Group Health provides employer groups with an affordable healthcare solution. This is achieved through a robust network of over 230,000 providers and supported by real-time claims management.

A key feature of the service is cost mitigation. This is managed through fixed-rate contracts and a suite of additional services, including pre-certification and case management. The plan also includes bill negotiations, which are used to control expenses when employees receive care from out-of-network providers.

The service is built on a patient-centered approach, with an experienced medical staff dedicated to ensuring quality care and effective medical expense control. The full range of group health services includes pre-certification, utilization management, large case management, medical bill auditing, bill negotiations, and field case management. All of these services are supported by a customizable platform with integrated MyMedlogix software.

How does bill negotiation work?

Bill negotiation is a process where a company, like Medlogix, acts on your behalf to reduce the cost of medical bills. They do this by contacting your healthcare providers—such as hospitals and doctors—who are not part of your insurance plan's network. Medlogix's negotiation team reviews standard payment rates (like UCR and Medicare) and uses this information to negotiate a lower price for the services you received. Once a new, lower price is agreed upon, they get a signed agreement from the provider to make it official.

What is the meaning of "out-of-network"?

"Out-of-network" refers to any healthcare provider, such as a doctor, hospital, or clinic, that does not have a contract with your specific health insurance company. When a provider is out-of-network, they haven't agreed to the pre-negotiated, discounted rates that in-network providers have. As a result, using an out-of-network provider almost always leads to higher costs for you, as your insurance company may cover less of the bill.

Not the page you are looking for? Here are our other pages

Auto Liability PPO (PIP)

Workers Compensation PPO