Programs

United Claim Solutions realizes the challenges that health care payors are facing. With today’s complex healthcare plans, UCS provides payors with simple, accurate, and secure methods to tackle the rapidly escalating cost of healthcare services. At UCS, we also realize that payors need these solutions delivered in a timely manner.

No matter which options you choose, you are always assured excellent customer service and a highly skilled staff to assist you with any of your needs.

Based on the needs of our clients we have developed the following three tiered program.

All Primary & Out-of-Network

For clients that wish to outsource all of their claims processing services both Primary PPO and Out-of-Network.

Partial Primary & Out-of-Network

For clients that wish to outsource some, but not all of their primary claims.

Out-of-Network Only

For those clients that wish to outsource only their out-of-network medical claims.

Services

UCS offers the majority of its services without requiring any long term contracts. We feel our performance speaks for itself.

UCS offers a variety of services to complement each program.

Primary – PPO Network Management

A number of UCS clients have chosen to outsource all their PPO relationships, so they can focus their attentions on driving new business as well as providing the best possible service to existing clients.  At UCS we are able to offer a large selection of both national and regional networks. We run disruption analysis with geographic reporting. Selection is available by access, savings or price. All of this is done on a PEPM basis with no additional fees.

Secondary/Wrap Networks

UCS is contracted with many national and regional PPO networks that can be accessed as a supplement to your group’s primary PPO.  We offer Expanded Savings (out of Area Program with network steerage and logos) and Immediate Savings PPO Repricing (Retrospective non-logo repricing). We accept all types of medical bills and have no dollar thresholds.

Direct Fee Negotiations

At UCS we have made a substantial investment in technology that enables us to deliver the largest negotiated discount rates in the industry. How do we achieve this?  We use the most comprehensive resources, including DRG, Medicare, Reasonable & Customarily, and Prevailing Rates. All of our negotiators are highly trained, seasoned professionals. They realize the importance of building trusting long-term relationships with both provider and facilities that are mutually beneficial to all. All negotiations are signed off by the provider or facility, with no balance billing to the patient. After working with UCS, many providers want to establish a formal contractual relationship. These contractual relationships, or continuous agreements as we prefer to call them, stay on record in our office and simplify UCS’s ability to access savings with these providers.

Transplant Savings Program

UCS offers a significant savings program through our relationship the Multiplan Transplant Network.

Workers Compensation-Occupational Accident

We have developed an effective workers’ compensation and occupational accident program that gets as close to a Medicare fee schedule as possible.