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Don’t Let Middlemen Get Between You, the Payer and Your Money!

Direct to Payer Billing and Payment

ClearPrice Networks mandates direct billing to the Payer by its Network Providers (or their designated outsourced billing agent) and direct payment by Payers (or their designated outsourced payment vendor) to CPN Providers. This streamlined process facilitates faster payment to CPN Providers and helps to keep administrative costs low. This direct billing and payment model improves reimbursement to CPN Providers, builds direct relationships with Payers, drives transparency into the process and serves as part of the foundation for a true partnership.

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Simplified Referral Fulfillment Process

For prospective orders referred to CPN Providers, CPN Providers receive an “authorization” directly from the Payer including the name of the Payer’s authorizing Adjuster.  CPN’s contract rates can also reduce annoying and unnecessary authorization and “renegotiation” calls from re-billing vendors and lower overall administrative costs.

Direct Contracts with “Clear Prices”

ClearPrice Networks (CPN) negotiates direct discount network contracts with both large and small Durable Medical Equipment, Orthotic, Prosthetic and Supply (DMEPOS), and Home Care Services providers. These direct contracts between Payers, CPN and CPN Providers feature prospectively negotiated “set” or “fixed” rates so there is NO DISPUTE regarding reimbursement.  CPN Providers get a “Clear Price” with every payment and Explanation of Review (EOR).  CPN’s contract rates can also reduce annoying and unnecessary “renegotiation” calls from re-billing vendors on each bill and lower overall administrative costs.

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Fast Payment and Price Transparency

After successfully completing the delivery of the medical equipment and/or service, CPN Providers bill the Payer directly and CPN Payers agree to pay all CPN Provider Network bills that are compensable, “clean” and ready for processing usually within 30 days of receipt of the bill.  ClearPrice Networks contract payment rates are established 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 CPN contracted Providers have complete visibility into the reimbursement rates at all times. 

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