Precision Pricing

A PPO Solution Using Data-Driven Pricing

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A Focus on High-Impact Claims for Maximum Savings

Precision Pricing strategically targets service categories that historically represent 2.5% of medical claims and drive over 60% of total plan costs.

By focusing on these high-impact areas, the savings potential is substantial.

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Not a Network Replacement:

Works alongside PPO networks and enhances savings

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Market Pricing:

Leverages market-based pricing

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Target Key Cost Drivers:

Reduces costs by up to 25% compared to traditional PPO networks

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Lower Stop Loss Premiums:

Leads to decreased stop loss premiums, amplifying your overall savings

Explore our strategic approach to managing high-cost claims.

How Does It Work?

Targeted Cost Control and Advocacy

Applies to claims above $5K in the following categories:

•     Hospital Stays

•     High-Cost Specialty Infusions

•     Hospital-Based Procedures

•     Post-Acute Care Facilities

•     Same-Day Surgical Centers

•     In-Home Medical Care Services Dialysis

•     Dialysis

•     Skilled Nursing

•     Hospice

A Better Experience for Members & Employers

Deliver superior healthcare experiences without the hassle.

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No impact on provider access, allowing continued use of the PPO network.

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Care Advocacy & Navigation team support:

•  Appointment scheduling

•  Pre-authorization support

•  Cost transparency

•  Guidance through the healthcare system

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Members are protected from excessive charges with guaranteed no balance billing.

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Ready to optimize your healthcare spend with smarter strategies?