Powerful solutions for today's healthcare marketplace.
Who we are
Relevant Healthcare Cost Containment® is an independent national healthcare cost containment organization offering a suite of solutions focused on the complexities of the U.S. healthcare system’s billing and reimbursement processes.
Our dedicated team approach provides world-class service levels and responsiveness, along with the flexibility required to offer all of our clients unique solutions based on their individual needs.
mission
Our mission is to deliver a healthcare marketplace built on financial transparency and cost-effective solutions.
vision
We envision a cost-saving marketplace that works better for patients, payors, and providers without sacrificing quality of care.
What we Offer
Our team of diverse business professionals has a combined experience managing over 250,000 diagnostic claims and has generated more than $250 million in medical savings.
Medical Claims Management
Our dedicated programs utilize reimbursement data & technological resources and are designed to reduce the total healthcare liability of self-funded companies.
Preferred Rate Programs
Through direct contracts with our diagnostic laboratory, imaging and surgical partners, we offer discounted rates on services performed in our network locations.
Medical Claims Management
Cost Reduction & Dispute Resolution
Our claims negotiation unit provides dispute resolution for claims of self-funded employers, including trustee and fiduciary claims, that result from balance bills from hospitals and providers due to the use of reference based pricing (RBP) or usual and customary pricing (UCR) for their employee health plans, and negotiation and settlement of medical claims for self-funded employer health plans of employers in bankruptcy, receivership, or restructuring.
Best-in-class negotiation
Our negotiation process uses public and proprietary data.
- Technical approach yields substantial savings
- Vast proprietary database on providers and their reimbursement acceptance tendencies
Audits, edits, & bill review
- Application of a proprietary platform that applies medical, clinical and reimbursement edits to further reduce costs
- Audit service which scrutinizes claims line-by-line
Provider claim settlement agreement
- Release for all provider claims
- Providers are bound to the settlement amount
- Agreement eliminates the potential for balance billing
Claims Integrity Solution
Our claims integrity unit delivers greater financial transparency, efficiency and savings to your health plan management process by utilizing an ever-evolving array of best-in-class technologies for our clients.
A cost-effective solution to minimize billing errors and overpayments
Today, increasing healthcare costs pose significant challenges to all health plans. Research has shown that almost 10% of all medical claims paid contain billing errors. Overpayments are one of the most significant factors.
We understand that for most companies, manually reviewing medical claims for provider error, fraud, waste and abuse is cost prohibitive. Our cutting-edge technology was designed to automate and improve the process.
Greater transparency of medical expenses improves bottom-line plan performance
Our Insight Engine performs a forensic-level analysis of our client’s claims data for provider error, fraud, waste and abuse (also known as Claims Integrity).
Insight Engine identifies and corrects billing inaccuracies in medical expenditures. It scans claims data in real-time and generates results in minutes – before overpayments are made – yielding efficiency improvements and savings opportunities.
Preferred Rate Programs
Diagnostic Laboratory Testing
Our diagnostic laboratory testing program is a turn-key solution that works with most major providers to offer deeply discounted allowed amounts on over 1,700 services to our clients for laboratory and diagnostic testing at over 4,500 locations, with no balance-billing to plan participants.
Now Offering Covid Testing Programs
Radiology & Surgery Concierge
Relevant’s concierge service is efficient and convenient for both plan administrators and patients to use. We handle pre-screening, eligibility checks, scheduling, and payment for services.
Our radiology contract rates are negotiated by pricing bundle and are inclusive of all costs and fees associated with the service at hand. We also offer discount pricing on several operations performed by our surgical partners.
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We'd love to hear from you.
Contact us today to learn more about how you can join us in our mission to move healthcare forward!
Send us a Message
Reach us through
-
227 West Monroe Street
Suite 2100
Chicago, IL 60606 - +1 (855) 328-5100
- info@relevanthealthcare.com