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Out-Of-Network

A standalone cost containment solution to enhance traditional network plans with significant cost savings for non-network claims.

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What is an Out-Of-Network Solution

Our Out-Of-Network (OON) solution provides essential access to services that fall outside the scope of traditional networks and uses Reference-Based Pricing (RBP) methodologies. 6 Degrees Health uses evidence-based data to provide a health plan and its members with significant cost savings on non-network claims.

 

Other Solutions

Clean Claim Reviews

We deliver industry leading savings and payment integrity with our experienced approach to comprehensive claim reviews that ensure accuracy.

Reference-Based Pricing

A data-driven approach to determine fair and acceptable healthcare reimbursements.

Transplant & Specialty

Let us expertly navigate the contracting and reimbursement process for your most expensive and complex procedures.

The Advantage of
6 Degrees Health

Our Out-Of-Network (OON) Solution allows clients to experience the cost saving advantage of reference-based pricing without replacing their traditional network. With our extensive RBP experience and proprietary data technology, we use a bottom-up pricing approach that results in significant savings for non-network claims.

  • RBP can save an average of 67% on out-of-network claims
  • Using objective and transparent data to provide a fair and reasonable reimbursement
  • Open access to seek care without network constraints
  • Coding reviews remove errors
  • Dispute and appeals support
  • Innovative plan language for customizable solution
  • Powered by MediVI, our evidence-based data technology
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We Leverage Proprietary Technology

MediVI is our innovative technology that aggregates multiple benchmarks and industry standard data to provide medical reimbursement analytics for clinical reviews, contracting, claim negotiations, and determining reasonable claim payments.

The Benefits of Working
with 6 Degrees Health

6 Degrees Health’s OON Solution far outperforms traditional out-of-network products. On average, our customers receive 67% OON net savings, a 99.1% claim acceptance rate, and an OON Medicare claim reimbursement of 139%.

Experienced Clinical and Negotiation Teams

Our teams are exceptional resources, no matter the complexity of the case.

Industry Leading Savings

Our RBP solution provides proven savings on out-of-network claims with almost zero member disruption.

Expand Access to Care with Secured Arrangements

We collaborate and optimize provider partnerships to achieve expanded access to care at a fair price.

Custom & Flexible Solutions

Our customizable cost containment solutions address the risk tolerance of your plan to achieve claims savings through RBP and secure arrangements.

Fair and Reasonable Reimbursement Structure

We use a bottom-up pricing approach with Medicare rates, provider costs, and other objective benchmarks to establish a reimbursement rate.

Advocacy

With our service-first approach, we manage provider access issues, appeals, and balance bills for members.

Are You Ready to See How Much Our OON Solution Can Save You!

Send us an out-of-network claim and we will show you the savings!

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