• Primary Networks
• Complementary Network
• Fee Negotiation
• Centers of Excellence

Solutions

MultiPlan is the leading provider of nationwide independent national PPO networks and related cost management services. We deliver the right solutions for today's healthcare payers and providers seeking a strategic response to the evolving managed care landscape. Tightly integrated and designed to work in combination with each other, our solutions deliver a single electronic gateway to a comprehensive set of claim cost management solutions that lower costs for payers and their health plan participants while helping providers to more effectively control reimbursements.

When our full solution suite is used, each electronic claim is compared against our cost savings mechanisms in a specific order, consistent with the requirements of our contracts and the relevant benefit plan. This results in predictable savings and maximum plan participant and provider satisfaction and avoiding errors and delays that often result when claims are routed from vendor to vendor:

• Step 1: Reprice through the primary PPO network
• Step 2: If the provider does not participate in the Primary PPO, reprice through the complementary network
• Step 3: If the provider does not participate in the complementary network, negotiate a reduction directly with the provider

For additional savings on transplants, MultiPlan also offers a nationwide Centers of Excellence network.