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Comprehensive Cost-Containment Services
H.H.C. Group is a full-service health insurance consulting firm founded to assist payors of health insurance claims and their clients with their Financial Case Management efforts. To this end, H.H.C. Group negotiates/reprices health care claims on behalf of our clients who pay for medical billings. Our highly skilled staff determine the most reasonable market level of pricing for each service or procedure. Then, we apply our knowledge base and experience to significantly reduce the client’s claim liability. We offer claim negotiation by licensed insurance professionals, repricing with over 250 national and regional networks, line item and comprehensive bill reviews (audits) and medical director and peer reviews through our URAC - accredited Independent Review Organization (IRO).
We request no payment unless and until we secure savings for our clients. HHC's focus is on the individual patient charge and we do not compete with the case management efforts of our clients. When negotiating or repricing, we make no medical decisions or judgements as it relates to the provider. We strictly evaluate the appropriateness of the charge.
To this end, H.H.C. Group provides comprehensive consultative services regarding the most current industry and strategic health management trends.
H.H.C. Group’s Financial Case Managers are licensed health insurance adjusters in New York, North Carolina, Florida, and Oregon; and, H.H.C. Group is licensed as a Medical Claims Review Agency in the state of Indiana.
Customer Service/Customer Satisfaction
Our comprehensive services are supported by excellent customer service. We know our clients have a choice of vendors, and we are committed to earning your business with each claim you send to us. We have an operations team that meets weekly to discuss and resolve any issues that arise for our clients; and, we work diligently to ensure that all of our clients’ cost-containment needs are satisfied. Some examples of our results follow . . .
2008 Medical Bill Review Program Examples
(SERVICE TYPE, AMOUNT BILLED, % SAVED, CLIENT SAVINGS)
NEGOTIATION $294,754.72, 30.00%, $88,426.72
NEGOTIATION $235,462.85, 30.00%, $70,638.86
NEGOTIATION $170,246.09, 40.00%, $67,828.44
REPRICING $ 68,304.86, 30.00%, $20,491.46
REPRICING $119,998.05, 30.00%, $11,999.80
REPRICING $ 59,440.20, 20.00%, $11,888.04
REPRICING $ 67,782.39, 15.00%, $10,167.36
LINE ITEM BILL REVIEW EXAMPLES:
(CASE, BILLED AMOUNT $, RECOMMENDED DENIAL $, % DENIED)
Case A: $130,484.30 $70,736.99 or 54.21 %
Case B: $ 76,132.00 $22,224.56 or 71.00 %
Case C: $236,338.88 $20,775.07 or 8.79 %*
*In-network claim reviewed for billing errors only.
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