Out-of-Network
Solutions

Payment Integrity

Precision Claim Review is a seamless proprietary analytical tool combining key components of code editing, bill review, compliance review, and industry benchmarks and reference points. It’s a key part of our cost management plan.

In addition, complex cases may be eligible for our additional clinical review and assessment. This process enables the OccuNet team to ensure the best outcome, resulting in secured savings and protecting members from any balance billing.

Long-Term Provider Agreements

A primary strategic initiative for OccuNet is to continuously secure and establish long-term agreements with select providers for our clients. These agreements allow OccuNet to minimize turnaround time and handle client claim volume more effectively.

The simplicity of provider agreements increases employee engagement in healthcare and group plans. This process also benefits providers by reducing administrative work on their end.

Air Ambulance

PPO Network Services

OccuNet offers a national supplemental/wrap network solution that can supplement & augment the overall strategy and value proposition for our clients through secured contractual agreements.

Established Reimbursement Level

OccuNet has developed an in-house proprietary established reimbursement level (ERL) solution to reprice non-contracted claims that can be utilized as a part of a comprehensive out-of-network strategy.