Many 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.

Request a Consultation

Find out how our network solutions are perfect for your enterprise.

Thank you for your message. It has been sent.
There was an error trying to send your message. Please try again later.