Claims Solutions:
Achieve Incredible Savings

MedWatch has solutions that generate significant savings on high-dollar claims such as dialysis, medical transport, high-cost pharmaceuticals, out-of-network and more.

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Dialysis Savings Program:
Pay Less - Much Less

Dialysis costs have been too high for too long, and are continuing to increase at alarming rates. MedWatch’s Dialysis Claim Pricing Program, recognized by the Validation Institute for our industry-leading process and defensible savings, provides a line-by-line clinical review that removes inappropriate charges and dramatically increases savings before repricing occurs.

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Clinical Review Average Savings

29%

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Dialysis Repricing Average Savings

63%

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Total Average Savings

92%

Reference Based Pricing:
A More Transparent and Fair Pricing Approach

MedWatch’s Reference Based Pricing provides clients a well-received and effective cost containment solution.

How Our RBP Program Works

Step 1

Member Support & Care Navigation

Support and Advocacy

MedWatch assists members with understanding their plan, locating accepting providers, and paves the way for member care

Step 2

Clinical Claim Review & Pricing

Clinical Claim Review

Our line-by-line clinical review identifies and removes any inappropriate charges, creating additional savings beyond typical RBP programs

Step 3

Member Advocacy & Billing Support

Defense from Balance Billing

If a member receives a balance bill, MedWatch supports the member and works with the provider to reach an acceptable outcome.

Additional Solutions to Manage High-Cost Claims

In & Out-of-Network Savings for High-Cost Claims

To address high-cost claims, MedWatch provides a clinical review process to remove inappropriate charges prior to repricing. The result is significant savings that are fully defensible.

Single Case Agreement Acquisition

There are circumstances where it may be beneficial to negotiate a single case agreement. MedWatch works with these providers to secure access to care at an acceptable cost on behalf of the member and plan.

Air & Land Medical Transport Savings

MedWatch helps minimize catastrophic out-of-network transportation claims and helps mitigate miscoding charges.

Explore MedWatch Services

Click below to explore our other services.

Pathways Concierge

Utilization Management

Case Management

Disease Management

Claims Solutions

Ancillary Services

Direct Contracts

Want to See More?

Request your own copy of our Services Overview!

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