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PAYERS

Experience the Savings Generated by Direct Access to Manufacturers, Suppliers and Distributors

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Rebilling

No Re-Billing Middlemen 
= No Hidden Markups

The ClearPrice Networks program eliminates the 30% to 50% markups added to health care providers bills by re-billing vendors.  PAYERS PAY THE RENDERING HEALTH CARE SERVICE PROVIDER DIRECTLY AND TRANSPARENTLY BASED ON THE CPN PROVIDER CONTRACT RATE, REFERENCE BASED PRICE OR NEGOTIATED AMOUNT.  The ClearPrice Networks program can cut approximately 10% to 35% off the price charged to Payers by re-billing vendors for both prospective referrals and retrospectively referred bills.

Network Discounts + Out of Network
Solutions = Maximum Savings

  • National Specialty Network of 4,800+ Provider Locations

    • ClearPrice Networks (CPN) negotiates direct discount network contracts with both large and small Durable Medical Equipment, Orthotic, Prosthetic and Supply (DMEPOS) vendors. All of CPN’s network providers meet strict licensing, credentialing and insurance requirements.  

  • Out of Network Solutions

    • CPN’s Referential Pricing 

      • Referential Pricing recommendations are developed using an extensive database of public, private and proprietary healthcare cost and payment data. 

    • CPN Bill Negotiations 

      • ​All CPN bill negotiations include signed “settlement” agreements to provide complete closure to all disputes​.

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Direct Billing + Direct Payment = Easy Implementation

  • Direct Billing & Payment

    • ClearPrice Networks mandates direct billing by its contracted CPN Providers and direct payment by Payers.  This streamlined process eliminates “TIN-FLIPPING”, “KILL-BILL” and other inefficient bill review processes used by re-billing vendors.  The CPN program facilitates faster payment and helps to keep administrative costs low. 

  • Easy Implementation

    • The CPN program is designed specifically to work seamlessly via EDI repricing bridges with bill review partners.  This repricing process has been in place for traditional PPO’s & networks for 30+ years, and can be “turned on” with CPN easily and quickly with your bill review partner/vendor.

Fraud Detection + Price Transparency = Trusted Partnership

  • Fraud Prevention and Detection 

    • Each ClearPrice Networks contracting healthcare provider is thoroughly credentialed and regularly screened by our fraud detection program.  

    • In addition, all healthcare provider bills repriced by ClearPrice Networks are checked against available federal and state databases during the repricing process to identify any current sanctions.

  • Price Transparency

    • ClearPrice Networks contract payment rates are established by contract, in clear, concise rate tables that comply with applicable state and federal fee schedules. There are no markups or hidden charges, and updates for new codes, equipment or services are uploaded at regular intervals. Both CPN Payers and Providers have complete visibility into the reimbursement rates at all times.

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