Negotiating out-of-network (OON) claims is a vital aspect of medical billing—especially for hospitals and freestanding emergency rooms. At Go Medical Billing, our specialized Negotiation Settlement Team brings decades of expertise in medical billing, coding, and revenue cycle management, with a strong focus on hospital systems and emergency care facilities.
Having Go Medical Billing handle your out-of-network negotiations and underpaid claim appeals ensures you’re not left at the mercy of insurance companies and their third-party vendors. These vendors often use complex tactics to reduce your reimbursements under the guise of policy limitations—but we know how to fight back effectively.
Go Medical Billing utilizes a proprietary Out-of-Network claims database and deep industry knowledge to negotiate underpaid claims on your behalf with both insurance companies and negotiation vendors like Multiplan, Viant, and Zelis.
We’re fluent in the language and tactics of negotiation and well-versed in the strategies used by insurers. Our goal is always to secure the most favorable rates for your practice or facility.
We advocate for both healthcare providers and their patients by using regional historical data to strengthen our negotiation position. Every claim is carefully analyzed to minimize out-of-pocket costs for patients while maximizing provider reimbursements.
With more than a decade of hands-on experience in both pre-payment and post-payment negotiations, Go Medical Billing has developed an effective, data-driven strategy that delivers results.
Insurance companies often cite employer preferences and limited-benefit policies to reduce payments. However, our negotiation team understands how to identify and challenge these limitations. By using our in-house OON data, we negotiate better rates—even in cases with restrictive policies.
We know how to re-price claims at optimal levels while ensuring compliance and full transparency throughout the process.
Pre-Payment Negotiation
Offers submitted by negotiation vendors on behalf of insurance companies before reimbursement. We review and renegotiate these offers to ensure fair compensation.
Post-Payment Negotiation
After a claim is paid—often at a reduced rate—we reopen the case and renegotiate to recover underpaid amounts based on actual value and service data.
Over 10 years of specialized OON negotiation experience
Expertise in working with top negotiation vendors and insurance payors
Proprietary database to identify and dispute underpaid claims
Strong track record of increasing reimbursements for hospitals and ERs
Comprehensive, aggressive approach to maximize collections
Let Go Medical Billing take care of your out-of-network claims so you can focus on delivering exceptional patient care while we handle the revenue challenges.
