CLAIMSBRIDGE NAVIGATOR - PRICINGMany self-insured organizations facing increasing healthcare costs consider reference-based pricing (RBP) models as a viable cost-containment strategy. RBP offers increased flexibility and transparency at reduced costs for employers while reducing out-of-pocket spend for employees.
ClaimsBridge Navigator Pricing Solutions simplify the implementation of referenced-based pricing and enable employers to choose the level of support they need to maintain an RBP model successfully.
Essential – The Essential offering includes comprehensive claims capture and pricing using the ClaimsBridge Celerity pre-adjudication engine.
- Application of Medicare pricing rules and establishment of MAC
- NCCI/MUE edits, gap filling
- Coordination of medical bill review
- Routing to network vendor(s)
- Web Portal and Landing Page creation
- Optional ClaimsBridge Navigator Network Access
Premier – The Premier offering includes all the great component services of Essential and adds advocacy and support:
- Collaboration with Administrator Service Team
- Customer Support tools
- ClaimsBridge Dedicated Support Line & Personnel to manage pre-certification, provider appeals, balance billing triage, and single case agreements, with Service Level guarantees
- ClaimsBridge Approved Legal Defense Partner
- Patient Advocacy
- Administrator selects stop-loss insurance
- Optional ClaimsBridge Navigator Network Access
Premier Select – The Premier Select offering includes all the component services of Premier with the addition of:
- ClaimsBridge approved stop loss partner
- Optional ClaimsBridge Navigator Network Access
ClaimsBridge Navigator Pricing Solutions are customizable and provide a single-source solution for a full RBP experience. Flexible add-ons and optional support services enable organizations of any size to implement a successful RBP model.
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