Proven

Results

* National individual and small group medical carrier
Sold business in 44 states, with claims in all 50 states and other territories

$327m in submitted OON charges for 121,437 priced claims

$226m in savings under ClearHealth program

69.2% gross savings on priced claims

Over 67% net discount after negotiating balance-billing inquiries

** National privately held multi-line carrier with self-funded and short-term health plan options

Create a non-network “PPO Replacement” plan to pay reasonable rates to providers

Has in-force of > 20,000 covered members on PPO Replacement product since January 2018 launch

$76m
in submitted total charges for 69,105 claims

$53m
in savings under ClearHealth program

69.1%
gross savings on priced claims

Over 62%
net discount after negtiating balance-billing inquiries

Short-term medical plan using a conventional national PPO network

$34m
in submitted total charges for 26,544 claims

$26m
in savings under ClearHealth program

77.3%
gross savings across all claims

*** National large third party administrator with multi-millions of covered members

Uses ClearHealth “Negotiation” services to augment other network and non-network discounts in a unique model to negotiate only above a certain threshold on large claims

$165m
submitted total charges for 3,533 claims

Requirement to negotiate, on average, below 40% of billed charges

17%
success rate on an excess discount with an average discount of 72%

$17m
in excess savings over and above existing discounts

National health plan offering self-funded and PPO Replacement plans

$251m
in submitted total charges for 202,589 claims

$152m
in savings under ClearHealth program

60.7%
gross savings across all claims

National third party administrator, largely out-of-network, but some PPO Replacement

$161m in submitted total charges for 159,001 claims

$103m in savings under ClearHealth program

63.9% gross savings on priced claims

Smaller regional third party administrator, largely out-of-network, but some PPO

$9m
in submitted total charges for 15,204 claims

$5.6m
in savings under ClearHealth program

63.5%
gross savings across all claims

Regional third party administrator, largely out-of-network but some PPO Replacement

$41m
in submitted total charges for 70,582 claims

$24m
in savings under ClearHealth program

58.4%
gross savings across all claims