Out of Network Negotiations

Out of Network Negotiation Technology

Our out of network negotiation settlement team will utilize their expertise and OON database
to negotiate on your underpaid claims with insurance companies and negotiation vendors
i.e. Multiplan, Viant, Zelis etc. on your behalf.
We know their terminology and we know all the tricks of negotiating the best rates for our
clients. Out-of-network billing is the trickiest aspect of billing, and we are well-known in this
industry as the experts in the field.
We protect your patients by carefully analyzing historical data based on your locality and
negotiate based on the analysis. BlssMedix ensures that we negotiate each claim, on your
behalf, as well as your patients, so that they are not stuck with a massive out-of-pocket
We’ve been navigating these insurance companies and negotiation vendors for more than 10
years on pre-payment and post-payment negotiations which helped us to create our own OON
database which we utilize to identify underpaid claims. We know that Insurance companies
utilizes employer preferences and limitations in determining reimbursement on your medical
claims but still our negotiation settlement team knows how to identify limited benefit policies
and employer preferences which help us to negotiate your bills on maximum re-pricing.

Pre Payment

Settlement offers received from Negotiation vendors on behalf of Insurance companies prior to
claim reimbursement.

Post Payment

Claim is reimbursed by the Insurance Company based on pricing provided by the
Negotiation/pricing vendor and claim is re-opened for Negotiation.

At the end, we advise you to use quality control procedures, structured billing processes, and appropriate out-of-network negotiation services to ensure error-free billing and maximum payments.