Out-of-Network Fee Negotiation

Healthcare Horizons offers fee negotiation for services rendered by out-of-network providers to reduce the payment required by a self-insured employer and eliminate balance billing or “surprise bills” to the patient.

While we offer fee negotiation for all types of medical services, our core competency involves negotiation for air ambulance services.

Air ambulance flights save many lives each year.  But for many carriers and self-insured employer plans, out-of-network charges for these services can be staggering – most are in excess of $50,000.  While fees charged by traditional medical transport services are regulated under the Affordable Care Act, air ambulance providers argue that they fall under the jurisdiction of the Airline Deregulation Act (ADA) of 1978, which prevents states from enacting or enforcing laws or regulations related to the price, route or service of an air transportation carrier. In addition, many air ambulance providers are out-of-network, which may result in surprise out-of-pocket bills for thousands of dollars.

Our familiarity with the industry, along with long-standing professional working relationships, allow us to approach air ambulance providers with a fee negotiation agreement that allows fair reimbursement for services rendered that is often much lower than the full billed charge amount. A successful negotiation provides savings to the self-insured plan and eliminates any balance billing to patients as the providers agree to write off the difference between billed charges and the negotiation amount.

Healthcare Horizons currently works with several major carriers to provide this service for our mutual self-insured clients. Our fee is based solely on a percent of savings achieved – if we are unable to complete negotiation, there is no fee to our clients.

Don’t miss this article:  The Self-Insurer: Why Self-Insured Employers Need to Negotiate Air Ambulance Rates