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RBP & Advocacy (Reference-Based Pricing & Advocacy)
Achieve Fair, Predictable Reimbursement with
Reference-Based Pricing
Reference-Based Pricing (RBP) is a powerful tool for controlling healthcare costs and ensuring providers are reimbursed fairly. EquitasDx helps providers implement RBP models that deliver transparent and predictable pricing, reducing disputes and maximizing reimbursement. Our Advocacy service further supports providers by negotiating with payors on their behalf to ensure fair reimbursement and resolve any discrepancies.
RBP Implementation: We guide you through the process of adopting a reference-based pricing model, ensuring it’s aligned with your cost structure and industry standards.
Claims Advocacy: If claims are underpaid or denied, we act as your advocate, using our deep industry knowledge and negotiation skills to secure the fair reimbursement you deserve.
Education & Training: We provide ongoing support and training to ensure your team is equipped to navigate RBP effectively and confidently.
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Claims Audits
Ensure Accuracy and Maximize Reimbursement with a Thorough Claims Audit
A small error in claims submission can lead to significant financial losses. EquitasDx’s Claims Audit service ensures that your claims are accurate, properly coded, and fully reimbursed. Our team conducts comprehensive audits to identify underpayments, overpayments, and billing discrepancies, allowing you to recover lost revenue and avoid future mistakes.
In-Depth Claims Review: We meticulously audit your claims to uncover errors and discrepancies that could impact your reimbursement.
Revenue Recovery: Our audits identify underpaid claims, enabling you to recover the revenue you’re entitled to.
Proactive Risk Management: By addressing billing and coding errors, we help you avoid future claim denials and delays, protecting your bottom line.