Repricing is as Easy as 1-2-3

Our three-tiered approach generates every savings possible, while being cognizant of provider concerns.

1. Accessing Secondary Networks to Obtain Claim Discounts

Network data is constantly updated to maximize savings. Utilizing a sophisticated rules engine, a hierarchy of networks are designed and administered, ensuring the largest impact on your claims. Ranked by state and discount history, each claim will achieve the best results at all times. With a base of over 100 networks, Global Claim Resources, Inc. provides increased savings, administrative ease and the utmost provider coverage.

2. Accessing Preset Discounts for Negotiated Providers

Global Claim Resources, Inc. has secured continuous discounts with thousands of providers nationwide. Providers that participate in our Preferred Provider Network are contractually obligated to accept the negotiated discount on an ongoing basis.

3. Medical Discounts Achieved through Expert Fee Negotiation

Fee Negotiation is a service that GCR utilizes for special claim situations. Claims that are not automatically re-priced are immediately forwarded to fee negotiation, resulting in the highest possible savings and shortest turn around time. Using an established procedure for successfully securing the highest possible savings, Negotiators obtain hospital and physician discounts, while maintaining a positive, mutually beneficially relationship with the provider.

GCR’s proprietary software allows negotiators to access claim history to leverage negotiating power. Supported by state-of-the-art technology and a wealth of industry knowledge, our highly qualified negotiators work with non-contracted providers to obtain the maximum discount on out-of-network claims. Settlements benefit providers by providing expedited payment, while acting as a safeguard from more erratic Usual, Customary and Reasonable cost reductions.

Average turn around is 1.2 business day
No charge limit on claim negotiations
Client determines claim turnaround time

Comprehensive Billing Solutions

Bill Review and Audit is designed to manage cost shifting techniques that cannot always be addressed in the repricing process. Particularly for large dollar claims, it has become increasingly important to employ an aggressive cost management strategy.

Global Claim Resources, Inc. utilizes an inter-disciplinary team of nurses, physicians, attorneys, and fee negotiators to review claims against objective reimbursement benchmarks and standards. Unreasonable charges, code bundling, and billing errors are identified through a line item analysis, while financial, medical, and legal reimbursement considerations are integrated into every audit recommendation. An average of 56% additional savings is realized.
Download a Faxable Bill Review Form.

Let Us Take Care of It

Global Claim Resource’s skilled team of friendly Provider Relations Representatives is dedicated to maintaining claim discounts. Any and all service issues or provider inquires can be directed to Global Claim Resources, Inc. for immediate resolution. Committed to delivering a good, equitable and sustainable agreement to both payors and providers, our provider relations representatives see discounts through to resolution. We communicate directly with the provider and PPO to confirm accurate discount agreements.

Providing Peace of Mind

Customer satisfaction is paramount to our company. GCR takes great pride in our ability to provide flexible, cost-effective, quality health care management solutions based on your organization’s specific objectives. Exceptional personalized service is our standard way of business. We are committed to working one on one with you to achieve your cost containment goals. Our team will do whatever it takes to insure clients are provided with optimum financial results, competitive pricing for our services and personalized Customer Service at every point of contact.