MultiPlan’s Analytics-Based Services

Taking cues from the data to customize solutions for out-of-network healthcare cost management

Balance Out-of-Network Savings and Member Service

Cost-based pricing

Patented, Consistent and Transparent

Validated by statisticians as effective and fair, Data iSight delivers deep savings on non-contracted claims/bills with wide provider acceptance.

  • Uses geographically adjusted, publicly-available cost and reimbursement data
  • Online explanations for providers, payers and patients
  • Integrated provider inquiry and patient advocacy programs
Negotiated agreements

Savings with No Balance Billing

Sophisticated financial benchmarks drive agreements that hold the patient harmless against provider balance billing.

  • 300 negotiators and support staff
  • Turnaround in 3.2 days on average
  • Portal and fax options for provider response and signoff
Other pricing methodologies

Traditional Pricing for Traditional Plans

Our medicare-based pricing as well as Viant pricing service offers time-honored methodologies for reducing out-of-network facility costs.

  • Outpatient pricing using usual and customary charges
  • Inpatient pricing using cost-to-charge ratios
  • Uses geographically adjusted, publicly-available data
Male and two females working on computers

Flexibility at its best

H3 green dash

Economic forces move the pendulum between maximizing healthcare savings and satisfying health plan members. MultiPlan offers a range of data analytics-driven healthcare cost management services that can be arranged and combined to help you strike the right balance not only today, but also when the pendulum shifts tomorrow.

A better reference for pricing

H3 green dash

There is a growing trend among healthcare payers to base reimbursement for non-contracted claims on Medicare reimbursement rates, under the name of Reference-Based Pricing. The problem is, Medicare is not only a flawed valuation for many healthcare services, but it also can deliver unintended consequences. The better measure is one that more directly ties to a provider’s own costs.

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 >
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 >

Negotiation by the numbers

H3 green dash
Over $5.4 billion reduced annually

Delivering savings with member protections on more than 3.6 million out-of-network claims/bills

Male and two females looking at computer screens

Unique position, different approach

H3 green dash

MultiPlan’s data analytics-driven healthcare cost management services work in concert with — or in place of — healthcare provider networks so you can align your strategies to fit the current economy. Do you need help preparing for the next pendulum shift?

Our website uses cookies. By continuing to browse, you are agreeing to our use of cookies. Read our Privacy Policy to learn more.