Renalogic is the leader in assisting the self-insured industry to manage all aspects of dialysis cost. The company’s professional team includes leaders in healthcare administration, legal specialists in ERISA and healthcare law, contract negotiation, and payer/provider negotiation, and clinical experts. Renalogic provides an end-to-end case and claims monitoring approach, built on the strength and proven effectiveness of its proprietary language and programs.
- Payment-based U&R program, which yields average savings of more than 80 percent off of billed charges
- Negotiations for single patient agreements
- Home Hemodialsyis Program
- Renal Data Management Program
Renalogic received a referral for a member from one of their reinsurance clients. The claims for this member were averaging $59,000 per month. The employer group had made the decision, during its most recent renewal, to amend its plan document to include Renalogic’s outpatient dialysis carve language for the application of U&R for these claims. In a 9-month period, the employer group achieved net savings on these claims of more than $350,000.
Self-Insured Employer Group
Renalogic was approached directly by a large manufacturing organization to manage this self-insured-plan’s strategies related to dialysis. Since 2009, Renalogic has repriced claims on four dialysis patients covered under the plan and achieved savings of more than $648,000 on billed charges of $829,293. No patient has been balance billed, and no claims have been overturned.
Renalogic received a referral from a client that included an entire year of dialysis claims totaling more than $370,000. The member’s claims had been sent in bulk by the facility due to eligibility issues that had just been resolved. The client’s hope was that Renalogic could successfully negotiate an agreement for this member for the year’s worth of claims and going forward. Renalogic was able to secure a single-patient agreement (SPA) at a daily treatment rate with a reduced contract rate for Epogen, administration, supplies and medications. The discounts from this agreement resulted in an average of 85 percent savings off the billed charges, preserved the member benefit and reduced the risk to the plan. When the plan for this member decided to change third-party administrators, Renalogic stepped in and successfully transferred the agreement from the previous client in order to retain the discount. The gross savings off billed charges continued at an average of 85 percent until the member was no longer primary on the plan.
Call Re-Solutions to learn more about how Renalogic can help you manage your dialysis costs.