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Claims Application Management Selects ClearHealth Strategies to Provide Medicare-based Pricing Services

Partnership provides access to ClearHealth Strategies' market leading Medicare-based pricing program.


News provided by

ClearHealth Strategies

Jun 03, 2014, 02:01 ET

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NAPERVILLE, Ill., June 3, 2014 /PRNewswire/ -- ClearHealth Strategies, the industry leader in Medicare-based pricing programs, announced today that Claims Application Management (CAM) has selected them to provide Medicare-based pricing for their customer base. CAM customers will have access to ClearHealth's market leading Medicare pricing program. CAM will be leveraging the Medicare pricing for its customers that are looking to replace their use of preferred provider networks entirely and also for customers that are looking to use Medicare rates as the centerpiece for their out-of-network pricing program.   

"We had been using a cost-based approach for our PPO replacement and out-of-network programs but we feel that switching to a Medicare-based program is clearly the way the market is moving," said Dennis Agar, President of CAM. "We feel Medicare is superior for a number of reasons including the transparency it provides to the provider community as well as the greater savings it provides to our customers."

The strategic agreement between the organizations provides CAM customers with seamless access to a complete Medicare-based pricing program. ClearHealth provides pricing for all 16 Medicare pricing and has extensive online reporting functionality.

"We are excited to provide our services to CAM and we look forward to continuing working with them in the future," said Bill Zaun, President, ClearHealth. "We are definitely seeing a migration from legacy pricing methodologies, including cost based, to Medicare-based solutions and this partnership will provide CAM with a key differentiator in the market."

There has been a fundamental shift in the cost containment industry recently with more and more cost management activity using Medicare-based pricing as the out-of-network standard.   ClearHealth's program of Medicare-based pricing, appeal management, and plan- or client-level configuration is uniquely positioned to help organizations move in this direction.

About ClearHealth

ClearHealth Strategies (www.clearhealthstrategies.com) is a leading provider of cost containment solutions to health plans, payers, third-party administrators (TPA's), workers compensation, property and casualty, and cost containment consultants. The company is rooted in deep knowledge and expertise building industry-leading claim negotiation and usual and customary approaches. The company offers Medicare-based pricing, claim negotiations, network routing, appeal management, and patient advocacy services in a software-as-a-service (SaaS) model.

SOURCE ClearHealth Strategies

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