Out-of-network (OON) Medical Claims Repricing

Capture Overlooked Claims Savings

Overview

Streamlined Service for Excellent Experience

Leverage our Fair Market Pricing services to capture often-missed savings opportunities. Reliant’s solution complements your primary network with similar savings results for Out-of-Network claims. See what our industry leading services can do for your plan. 

74%

Savings Rate

0.26%

Appeals Rate

0.05%

Claims Appealed with Additional Payments

Features

Fully Managed Out-of-Network Savings

We’ll collaborate with you to design the best OON savings solution for your needs. You can even choose your own custom balance of aggressive savings vs. appeals risk, thanks to our flexible approach. And because our system learns from every claim we process, you’ll see your results steadily improve over time the longer we work together.

  • Customized balance of cost vs. noise

  • Comprehensive No Services Act (NSA) solutions

  • End-to-end appeals management

  • Best-in-class fraud, waste, and abuse screening

  • Industry-leading security + HIPAA compliance

Partnering with Clients Nationwide

  • “I was blown away when I saw the substantial network gap Reliant’s solution solved. Our clients have been thrilled with the savings, and the Reliant team has been a dependable partner. I am excited to continue growing our relationship together.”

    – John Folks, Vice President of Client Development, NovaNet

  • “Reliant’s comprehensive and dynamic Fair Market Pricing solution has allowed our clients to reduce and control cost in a meaningful way. Not only that, but the team went above and beyond to tailor their solution to fit our unique turnaround time needs.”

    – Mike Stuart, Managing Partner, Quantum One Networks

  • “I have known the Reliant team for many years and can’t speak highly enough of them both professionally and personally. Reliant’s combination of high savings and minimal noise has equipped us with a major advantage in showing unique value to our clients. I can confidently say the Reliant solution is unmatched in the market.”

    – Bill Nantz, Senior Director of Network Services, Rising Medical

  • “We have written a lot of Reference-Based Pricing groups over the years and that has resulted in good savings but has come with challenges. Reliant’s solution is the best of both worlds, and we are very excited about continuing to grow with them going forward.”

    – Southeast TPA

  • “Reliant has been a great arrow in our quiver for winning new business. They are a fantastic alternative to other, more disruptive re-pricing solutions. Reliant has made all the difference for many of our groups. Our customers see the value Reliant delivers over the long-term.”

    – Donn Duhon, Vice President of Business Development, Employee Plans

  • “Reliant promised they could deliver great results and they have! Our partnership has evolved over the last 8 years as we continue to experience incredible savings. Having a trusted and proven partner like Reliant, helps our accūrō team deliver superior results for our clients and continue to grow.”

    – Lisa Gran, Chief Revenue Officer, accūrō Solutions

Case Studies

Tailored Strategies for Maximum ROI

Maximizing ROI with Creative Solutions

How a northeast brokerage saved their clients $317 million on OON coverage

Read the Case Study →

Next Steps

Customize Your Out-of-Network Savings Strategy

Let’s create an out-of-network plan to get you maximum savings with minimum noise! Book your free consultation, and get a custom savings analysis based on your actual OON claims to see what you could save with Reliant.