Claims Repricing

We’re here to provide you with enhanced healthcare cost management solutions that lower costs and improve health outcomes

AnnexMed Blog

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  • 197 State Route 18 South
    Suite 3000, South Wing
    East Brunswick
    New Jersey 08816
  • info@annexmed.com
  • 1-866-780-0669
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Take Control of your Claim Repricing Confusion

Claims repricing is an alternative to traditional health insurance plans that provides individuals and companies with affordable health insurance. Discounts can usually vary depending on the services rendered because different pricing strategies are used for different plans, such as POSs, HMOs, and so on. AnnexMed enables health plans to implement claims repricing processes to ensure that their claims are correctly and timely adjusted. We provide knowledgeable resources to assist health plans in reducing appeal times and saving money by contacting providers for sign-off on discounts.

AnnexMed currently processes over a million healthcare transactions annually with a 99.5% accuracy rate. We help with the management of claims operations ranging from Form Submission through Mail Room Management, Indexing, and Adjudication to payments. For larger claims, we double-check with the network to ensure that the provider is currently contracted with them and that the discount applied is valid, minimizing the possibility of reversals. We support the automation of voluminous and repetitive processes, as well as in enabling data-driven decisions using advanced technologies, which improve efficiency, accuracy, and service quality for our healthcare clients.

Claims Repricing capabilities include:

Provider Table
Maintenance

Larger Claims
Management

Managing Adjustment
and Evaluation

Expertise Claims
Department

Timely Repricing
of Claims

Insurance Data
Analysis

Service Highlights
  • Out-of-network repricing
  • End-to-end Medical Claims Processing
  • Manual Repricing of Claims
  • Claims sent to PPO for Repricing
  • Alternative Reimbursement strategies
  • Fraud Detection
Benefits
  • Quick turnaround time for claims processing
  • High Accuracy Standards
  • Strong Governance processes
  • Daily Repricing Reports
  • Reduces costs by as much as 30-40%
  • Leveraging the knowledge of billing professionals

20%

Increase in
payment recovery

100%

Member
Satisfaction

30%

Reduction in
administrative cost