We simplify one of the most challenging aspects of healthcare finance, Out-of-Network (OON) Negotiation.
Our seasoned negotiators bring decades of expertise in medical billing, coding, and revenue cycle management, helping hospitals, urgent care centers, and free-standing emergency rooms recover the payments they truly deserve.
Dealing with the insurance carriers and third-party negotiation vendors like Multiplan, Viant, and Zelis can be frustrating and time-consuming.
Our OON specialists handle this complex process for you, securing higher reimbursements, reducing underpayments, and protecting your patients from excessive out-of-pocket costs.
Step | Process | Outcome |
Claim Evaluation | We review every denied or underpaid OON claim and verify payer data. | Identify gaps and negotiation opportunities. |
Data-Driven Benchmarking | Compare with historical and market-specific OON databases. | Establish fair pricing standards. |
Pre-Payment Negotiation | Handle settlement offers before payment release. | Achieve the best rate before insurer payout. |
Post-Payment Re-Negotiation | Re-open claims that were underpaid after processing. | Recover lost revenue through re-negotiation. |
Documentation & Compliance | Prepare all supporting documentation with legal and compliance accuracy. | Ensure defensible and compliant claims. |
Reporting & Insights | Provide transparent reports with recovery metrics. | Keep you informed with actionable financial insight. |
We the years of OON experience to negotiate directly with insurance companies and pricing vendors. Our deep understanding of payer tactics helps us achieve the maximum settlement rate for every claim.
Our in-house database is built from years of claim history and market-specific benchmarks. This data-driven approach enables us to identify underpaid claims and negotiate fair, evidence-based reimbursements.
Each claim undergoes a detailed audit to identify missed opportunities and underpricing. We ensure your practice receives every dollar it’s owed.
Our team doesn’t just negotiate for you. We advocate for your patients. By reducing unreasonable out-of-pocket liabilities, we protect your relationships and reputation.
Your data security and HIPAA compliance are our top priorities. All negotiations, documentation, and correspondence are handled through secure, compliant systems.
From pre-payment to post-payment settlements, we focus on real, measurable outcomes. Improve cash flow, increase the reimbursements, and increasing total revenue recovery.
Every out-of-network claim comes with its own set of documentation requirements and payer rules. Our expert team ensures accurate claim preparation and effective insurer negotiation, helping your practice secure fair reimbursements, reduce claim denials, and remain fully compliant with regulations.
This approach streamlines out-of-network patient medical billing and inquiries, providing both providers and patients with a smooth, clean, and reliable billing experience.
Partnering with us ensures smoother billing processes and faster payments for your practice. Our team reduces administrative workload and resolves patient inquiries efficiently.
Improves overall revenue collection. You gain complete transparency, secure handling of sensitive information, and expert support throughout the billing cycle.
Improve your patient experience and optimize your revenue with Cures Medical Billing’s Out-of-Network Negotiation Services.
Our team handles every detail, from claim review to insurer communication. Ensuring fair reimbursement while keeping your practice fully compliant.
We manage the complexities of out-of-network billing and negotiation. Contact us today to schedule a consultation and streamline your out-of-network patient billing operations.
Years of Experience
Medical Specialties
Happy Clients
Out-of-Network Negotiation involves negotiating with insurance carriers or their third-party vendors to determine fair reimbursement for services provided by non-contracted providers.
Outsourcing saves time, prevents lost revenue, and ensures professional negotiation with payers using data-backed strategies and compliance expertise.
We use a combination of proprietary data, payer insights, and experienced negotiators to achieve higher re-pricing on underpaid or denied claims.
Pre-payment negotiation occurs before claim payment, while post-payment negotiation involves reopening and re-negotiating claims that were already paid at lower rates.
Absolutely, Cures Medical Billing maintains 100% HIPAA compliance, ensuring full data security and confidentiality at every stage.
Yes, our experts can review your historical OON claims and re-negotiate underpaid ones within the insurer’s appeal window.
Any healthcare facility that serves out-of-network patients — including hospitals, ERs, ASCs, and urgent care centers — can benefit from our specialized negotiation services.
Efficiency & precision in healthcare financial management with Cures Medical Billing, your trusted partner for smarter, faster, and more accurate billing solutions.
