6 Degrees Health
Member Level: VendorVendor Overview
Description of Services: Since 2012, 6 Degrees Health has been using our proprietary data and cutting-edge software, plus years of industry experience to help solve some of the most complex issues in healthcare. We take a service-first approach to our Clean Claim Reviews to ensure accuracy in billing and fair payments. Using our extensive cost containment experience and clinical expertise, we conduct the reviews in accordance with industry standard guidelines and evaluate every line item to identify and remove billing errors and inconsistencies.
Our clinical reviews are completed by registered nurses to ensure each billed line item, including routine supplies and services, pharmacy charges, laboratory, level of care, and implants are correct. This detailed review removes erroneous line items and verifies billing accuracy. The Clean Claim Review process identifies errors on the claim which cannot be balance-billed to the member and may also help reduce stop-loss premiums.
Our comprehensive process manages claims during the review stage, as well as through payment, resolution, and appeals. Simply by leveraging our pre-payment reviews for healthcare services already rendered, health plans can see incredible savings.
Additionally, we offer an Out-of-Network solution that provides essential access to services that fall outside the scope of traditional networks and uses Reference-Based Pricing (RBP) methodologies. 6 Degrees Health uses evidence-based data to provide a health plan and its members with significant cost savings on non-network claims that far outperforms traditional out-of-network vendors.
Primary Service: Claims
Secondary Service: Administrative Systems
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3439 NE Sandy Blvd.
Suite 384
Portland, OR 97232
503-640-9933
http://www.6degreeshealth.com