Out-of-Network Services – Maximize Reimbursements with Expert Negotiation, Appeals & IDR Support
Navigating out-of-network reimbursements can be challenging, with many providers facing lower payments, delayed reimbursements, or outright denials. Studies show that over 30% of out-of-network claims are initially underpaid or denied, leading to significant revenue loss. At BillWell, we specialize in strategic negotiations, appeals, and Independent Dispute Resolution (IDR) services, ensuring you receive the highest possible reimbursements with minimal administrative burden.
Pre-Payment Negotiations – Secure Higher Initial Payments
Many payers undervalue out-of-network claims, often leading to payments as low as 10-30% of billed charges. Our expert negotiators work after the patient visit but before the payer issues payment, ensuring fair and maximum upfront reimbursements.
Direct Payer Negotiations
We leverage industry benchmarks and payer data to negotiate fair and competitive reimbursement rates before payment is issued.
Claim Tracking & Follow-Up
Our team diligently monitors each claim, ensuring timely processing and reducing the risk of delays or underpayments.
Minimized Hassle for Your Team
We handle every aspect of pre-payment negotiations, allowing your staff to focus on patient care instead of reimbursement battles.
Appeal Services – Recover Revenue from Underpaid or Denied Claims
Out-of-network claims are significantly more likely to be denied, and many providers lack the time and resources to fight for proper reimbursement. BillWell’s appeals specialists work to recover lost revenue on claims denied or underpaid for up to 12 months after submission.
Denied & Underpaid Claim Appeals
We analyze each claim, identify errors, and present strong appeals backed by medical necessity documentation and legal precedents.
Payer-Specific Expertise
Our team understands complex payer policies, giving us the edge in challenging underpayments and denials across multiple insurance carriers.
Proven Track Record of Success
With over 70% of denied out-of-network claims being overturned on appeal, our process ensures you get the reimbursements you deserve.
Timely Filing & Resubmission
We manage deadlines, ensuring appeals are submitted within each payer’s timeframe—maximizing your chances of approval and payment.
IDR Services for No Surprises Act Compliance
If your out-of-network claims fall under the No Surprises Act (NSA), BillWell offers Independent Dispute Resolution (IDR) services to challenge unfair payer reimbursements. Our team navigates the arbitration process, presenting compelling cases to secure the payments you rightfully deserve.
Don’t Leave Revenue on the Table – Partner with BillWell
Without an effective out-of-network strategy, your practice could be losing thousands to millions in potential reimbursements. BillWell’s expert negotiation, appeals, and IDR team ensures you receive the highest possible payments with the least amount of hassle.