Precision Pricing
A PPO Solution Using Data-Driven Pricing
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.
Not a Network Replacement:
Works alongside PPO networks and enhances savings
Market Pricing:
Leverages market-based pricing
Target Key Cost Drivers:
Reduces costs by up to 25% compared to traditional PPO networks
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.
No impact on provider access, allowing continued use of the PPO network.
Care Advocacy & Navigation team support:
• Appointment scheduling
• Pre-authorization support
• Cost transparency
• Guidance through the healthcare system
Members are protected from excessive charges with guaranteed no balance billing.
