We excel at self-funded and group health claim review.

Group Health Claim Review

Hopewell Risk Strategy’s bill review product is designed to provide significant reductions in medical claim costs in concurrence with timely and accurate payment recommendations.  Hopewell Risk Strategy provides industry leading medical claim review services. We provide state-of-the -art bill review and repricing solutions for group health medical claims. Average savings on out-of-network claims is 53%.

Fee Negotiation

Hopewell Risk Strategy’s team of experienced negotiators combined with our proprietary databases secures deep discounts on medical claims with a full release of liability so patients are not balance billed. 20% Average Negotiated Savings It’s All About The Bottom Line!

Patient Advocacy

Hospitalization and illness can be very stressful. Combine this with medical bills that are artificially inflated and you may need someone to speak for you. Hopewell Risk Strategy’s Patient Advocacy program plays a critical role in helping members and dependents with their healthcare costs.

Are healthcare costs bleeding your business dry?

Hopewell Risk Strategy is a cost containment company specializing in group health medical claim review. For two decades we have provided high-quality customized bill review of workers’ compensation and group health claims for self-insured private and public entities throughout all fifty States.

Since our founding in 1994, we have made it our priority to listen to our clients and tailor our services to their special requirements. Our reviews are defensible and supported by major preferred provider organizations.

In network claims review

Your plan administrator has a PPO arrangement in place to provide discounts for provider services.  That’s great.  However a discount applied to something that doesn’t belong on the bill in the first place isn’t great and isn’t a discount.  So far, in 2015 our in-network claim reviews have averaged 19.65% in savings above any existing contracted discount.  Just because it is billed doesn’t mean it should always be paid.  You have the right to determine your plan’s liability on all claims.

Outpatient repricing and review

Fair evaluation and pricing of claims

Over $500 billion in annual over payments are attributed to outpatient care

Did you know that the highest sector of healthcare cost increases start with outpatient services? Over $500 billion in annual over payments are attributed to outpatient care.  Our suite of comprehensive review practices identifies and brings about fair evaluation and pricing of claims.

Out of network claim review

Paying 1,000% or more than someone else pays for the same service hurts

Don't live with absurd upcharges

Paying 1,000% or more that someone else pays for the same service hurts.  The upcharges you find on just one non-network claim can destroy a plan’s loss ratio and with the decline of PPO networks, non-network claims can become more common.  Our tested solutions have generated savings of 57.13% so far in 2015.  We contour the strength of Hopewell’s reference tools to protect your plan’s assets.

Implant Review and Pricing

We make recommendations for fair and practical provider compensation

CHARGES FOR IMPLANTS ARE OUT OF CONTROL

A facility provides no value added service, other than obtaining an implant and making it available for a surgical team.  There is no reason an artificial knee – sold to the hospital for less than $4,000 should cost your plan $36,000.  It is our policy to review implant invoices and make recommendation for fair and practical provider compensation.

Patient treatment agreements

More structured payments take the strain of self-funded health plans

21 years of experience

Leveraging our 21 year history of successful treatment agreements and claim negotiations makes since.  These agreements can take the strain off of a self-funded health and welfare plan which allows for a more structured payment methodology which means significant savings.

Post payment review

A post payment review can provide a wealth of information on how your contracted plan is performing.

Over payments need to be credited back to you

Hopewell Risk pioneered the art of post payment review in 1994 and since then we have amassed significant plan savings after incorrect or inaccurate payments have been made by third parties.

Patient advocacy

We work directly with your members to help reduce or correct medical bills

We help reduce the pain of inflated medical bills for your members.

Hospitalization and illness can be very stressful. Plan participants can rely on the expertise of a Self-Funded Texas advocate to assist them in dealing with non-eligible carrier issues after other means have failed to resolve the payment issues.

Who We Serve

What Else? We Have The Best Support Around

  • Customized services to customer’s specifications

  • 5 Day or Less Turn Around Time

  • EDI Capability

  • Alignment with Plan and PPO Contracts

Contact Us Today!