Strategic Cost Containment Services
Reference Based Pricing
Integrated with our Inpatient and Outpatient Precertification program, MedWatch will access pricing and provide the approximate dollar amount payable to providers at the time of pre-cert. Click Here to Learn More!
In and Out of Network Claims Review
Maximum savings, deep discounts, and the capability of impacting the majority of Out-of- Network and Large In-Network claims.
- Out-of-Network claims repriced with savings averaging 54%
- In-Network savings average 21% above and beyond the PPO discounts
- Specialty Dialysis Negotiation program, capped rates, specialized Plan Language suggestions
- Medicare Plus Repricing
- Legal backing, support and defense of the claim for the life of the claim; Provider Sign-off as requested
Bundle Payment Programs
MedWatch offers bundled solutions that significantly reduce healthcare costs through pre-negotiated, all-inclusive pricing, then combines services and fees into a single line item claim that simplifies the payment process. These programs adhere to the highest quality standards for care and utilize accredited physicians and facilities to provide services and treatment regimens. Some programs may require plan language identifying them as network carve-out services.
Pharmaceutical Treatment Bundles
Up to 85% savings on pharmaceutical treatments utilizing FDA approved name brand and generic drugs. Through Joint Commission Accredited facilities abroad, bundled treatment programs are inclusive of travel, accommodations, consultations, professional & facility fees, medications and follow up visits as required.
Surgical Bundles
Potential savings of 25% - 50% over and above PPO rates on a wide range of common surgical procedures through our national network of state licensed facilities with qualified surgeons. Bundled surgery programs are inclusive of consultations, professional & facility fees and follow up visits as required.
Substance Abuse & Mental Health Bundled Program
Joint Commission Accredited with Dual Licensing, our MH/SA Bundled Program provides measurement-based care for adults and adolescents with mental health conditions, substance abuse disorders and dual-diagnoses. It offers a variety of highly specialized and effective programs with COE facilities located across the U.S. providing a holistic approach to behavioral health services that promote recovery and achieve substantial savings with optimal outcomes. Case rates vary based on diagnoses and individual needs.
Solutions for Substance Use Disorders
Estimated relapse rates for substance abuse ranges from 80% - 90% within the first year. MedWatch offers a highly effective post-discharge substance abuse program, delivers long-term support, increases patient engagement and improves clinical outcomes. Certified peer recovery support specialists leverage tech-enabled tools such as telehealth, remote devices and applications to engage and support patients as they seek long-term recovery. With patient consent, this multifaceted approach involves family and providers to strengthen engagement, reduce readmissions, lower utilization of high cost services and improve the participant experience. This solution extends the care continuum by 12 to 18 months and data demonstrates significant reduction of downstream treatment readmissions, ER admissions and out-of-network exposure.
Air & Land Medical Transport
MedWatch addresses the excessive costs of medical transportation and provides a concierge service to work with the plan and their members for verification of benefits and eligibility, prior authorization, coordination of transferring/receiving facilities including bedside-to-bedside transport. Clients can eliminate catastrophic out-of-network transportation claims, recover abusive charges from miscoding and inappropriate transports and coordinate with re-insurers for discounts and credits.
Want to see more?
Use our contact form to request a full Menu of Services from our client services team!