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Summit Re is pleased to announce that it has entered into an agreement with National Care Network (NCN) for its medical cost containment services. NCN is a privately-held organization based in Irving, Texas, and provides its services to large insurance carriers, self-funded organizations, third party administrators, health maintenance organizations, employer groups and reinsurance carriers across the country.
NCN's core solutions for out-of-network claims include Fee Negotiations, Supplemental Network Repricing and Hospital Detail Analysis, which is a Medicare-based pricing methodology. NCN has achieved many milestones in its fourteen years of operation including being the first in its industry to receive the URAC Core Accreditation; establishing HIPAA compliant EDI transactions; developing on-line tools for client access of claim tracking and reporting; and reviewing billions of dollars in medical charges.
While NCN has been extremely successful in saving its clients millions of dollars with these products, they realized that neither they, nor other cost containment companies, were doing enough to reduce overall healthcare charges. A product needed to be developed that allowed for fair reimbursement based on the facility's costs to provide care. Further, the benchmarking of like facilities needed to reflect the variances within facility costs, the pricing methodologies needed to be flexible to meet the clients' needs and all pricing recommendations needed to be transparent to the payer, provider and member.
After a year and a half in development with Data Advantage, a company NCN acquired in 2005, NCN recently introduced Data iSight to meet all of those needs. Data iSight leverages nationally recognized data sets to enhance provider understanding and acceptance; reviews both the financial and clinical components of a claim; incorporates cost-based awareness; and provides a transparency component for providers, payers and members. Data iSight will generate fair reimbursement recommendations that generate legitimate savings.
NCN provides each client with a dedicated team to ensure consistent success that will help you meet your overall savings objectives. To learn more about NCN, please visit their website at www.nationalcarenetwork.com or you may contact Debbie Stubbs, RN,MS,CCM, Managed Care Specialist at (260) 407-3979. Together, Summit Re and NCN look forward to working with you.
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