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Customized solutions for the commercial market

Helping healthcare payors and their plan members strike the ideal balance between service quality and cost

By the numbers

Over 700 healthcare clients

Representing thousands of insured and self-insured groups

Over $27 billion in-network claims repriced annually

Annual reductions across all network services

Over $15 billion in out-of-network charges reduced annually

Annual reduction across all non-network services

Over $3 billion in payment integrity reductions annually

Annual reductions across all payment integrity services

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Our services in action

Customize a solution to solve any healthcare cost management problem

Choose and arrange from the industry’s richest set of services designed to reduce medical spend before you pay.

Payment Integrity – What We Find

Complex issues (60%)

Many findings need physician and/or code review to confirm:

Suspect scenarios (10%)

Needs physician review and may require more documentation:

Simple issues (30%)

Generally found by claim editing software, but often overlooked:

Defensible and effective pricing

Whether using networks or not, it’s always better for a plan and its members to work in tandem with providers, and not against them, to manage medical spend. For pricing of non-contracted claims, MultiPlan’s Data iSight and Viant services offer defensible methodologies, integrated provider inquiry and resolution management, and a unique patient communication program designed to deliver support when balance billing does occur.

 

Learn more about why Data iSight has over 90% provider acceptance.

Our commercial healthcare networks

Network Hospitals

4,800 primary & 5,000 complementary

Ancillary Care Facilities

94,000 primary & 113,000 complementary

Network Practitioners

797,000 primary & 836,000 complementary

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Case Study: Retaining important business

MultiPlan analysis helped a third-party administrator defend against a competitor’s push to implement Medicare pricing by:
significantly improving savings for the employer and its members; engaging important providers in the new process; and preserving the community’s provider-patient relationships.

Read more >
Female and two males looking at paper and laptop

Case Study: Retaining important business

MultiPlan analysis helped a third-party administrator defend against a competitor’s push to implement Medicare pricing by:
significantly improving savings for the employer and its members; engaging important providers in the new process; and preserving the community’s provider-patient relationships.

Read more >

Contact us

Improve competitiveness and reduce medical spend. Use MultiPlan’s payment integrity and cost management services to customize solutions for you and your clients.