HPO
(Health Payor Organization)
A Customizable Out-of-Network Solution
Out-of-network claims are one of the most frustrating and expensive challenges your clients face. Members want provider choice. Plan sponsors want cost control. Administrators need a solution that is easy, adds value, and that’s strong enough to reduce noise and costs.
HPO (Health Payors Organization) helps you deliver out-of-network savings without adding unnecessary administrative burden. It captures and reprices out-of-network claims through a national complimentary network supported by provider contracts, partner networks, and fee negotiation services. That means your clients can reduce the financial impact of out-of-network utilization while giving members access to fair, contractually negotiated rates.
Just as important, HPO also helps reduce claims that may otherwise require Qualified Payment Amount handling, Independent Dispute Resolution, or forced negotiations under the No Surprises Act.
It works with all kinds of health plans, benefit designs, networks, group types, providers, point solutions and products. Logo and non-logo ID card options are available, and minimal access requirements help keep things simple. Claims repricing is fast and efficient through EDI connectivity, helping providers get paid promptly and reducing disruption.
If your clients need a better way to manage out-of-network claims, HPO is ready to help you deliver savings, simplicity, and confidence.
Discounts greater than 35%
on over 85% of claims