Out-of-Network Impact

Don't settle for an arbitrary percentage

Out-of-Network Repricing

Whether through preset discounts or averages based on average multipliers of Medicare, billing errors, anomalies, and abuse are often overlooked under the guise of set savings. WellRithms’ in-and-out of network review and repricing process makes sure that doesn’t happen.

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Savings Impact

Average savings across all repriced out-of-network claims

Sustainable Claims Pricing™ (SCP)

Revolutionizing the way out-of-network and catastrophic healthcare bills are adjudicated.

WR will perform SCP repricing for non-network, out-of-network, No Surprises Act eligible claims, or other identified medical claims meeting certain criteriaSCP is grounded in the English common law principle of quantum meruitClaims are reviewed for accuracy and repriced according to the usual, customary, and reasonable industry standards using formulas that are backed by case law and are consistent with open price termsSCP considers reasonable industry standards and local market realities.

  • Control the rising costs of out-of-network claims
  • Pre-payment repricing to capture savings on every claim
  • Bend the trajectory of health plan spend
  • Patient balance billing solved
  • Minimize provider appeals while maximizing savings with fair reimbursement
  • A better option than rental PPOs for cost containment

Air/Ground Ambulance Repricing

Revolutionizing the way out-of-network and catastrophic healthcare bills are adjudicated.

Air and ground ambulance bills often come with hidden fees and complicated charges that aren’t easily understood or caught. WellRithms untangles complicated bills and provides the transparency payors deserve. Our rigorous system can spot unbundled charges and assess transport services based on medical necessity, ensuring that every bill is accurate before payment is made. We maintain the integrity of the bill so payors never pay more than a fair and reasonable price.