NU Online News Service, Aug. 16, 5:15 p.m. – American Health Holding Inc., Westerville, Ohio, a managed-care administrative services company, has won a contract to provide medical service repricing services for Administrators West, Seattle, a third-party benefit plan administrator.
Most health plans now use networks of doctors and hospitals that have agreed to provide their services at a discount. Many doctors and hospitals also offer discounts even when they are not in a patient’s network.
A repricing service determines how much a health plan actually has to pay for the medical services a member has received.
Administrators West has agreed to use American Health to handle repricing when patients see doctors and hospitals outside of the Administrators West network.
Out-of-network repricing savings average 15% to 22% of the retail price, American Health says.
American Health says it can often negotiate savings of 10% to 18% even when out-of-network providers are not offering official out-of-network discounts.