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Our clients report that 8 to 10 percent of all claims received are Out of Network. Out of Network claims are reviewed by RPS's Usual, Customary, and Reasonable databases which bring the charges to customary levels as provided under most insurance programs. RPS's highly skilled staff of Registered Nurses reviews every line of the supporting hospital claim itemization, identifies, and adjusts inaccurately billed items.

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Our highly experienced staff will produce significant savings through negotiation with facilities for reduced fees. This service is available to Insurance Companies, Attorneys, Third Party Administrators, self-insured groups, and governmental agencies.

Each negotiation results in a full release of liability so patients are assured they will not be billed for any remaining balances. Renal Dialysis costs have spiraled out of control and are dramatically impacting costs for both the patient and the health plan.

PPO's have been ineffective in addressing this area and the typical fees charged by others to "save money" is so much each month that Payers and Health Plans feel as if they are being gouged and are demanding a different solution.

Resource Protective Services is a company truly focused on controlling cost in every way including in their fees.

Our proven outcomes result from a combination of our outstanding clinical and professional staff and our proprietary software system containing more actual payment history than any in the industry. Hospitalization and illness can be very stressful. Combine this with medical bills that are artificially inflated and you may need someone to speak for you. Our expert client service staff is able to act as your medical accountant.

They're well versed in the ins and outs of medical billing and know how to:.

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Review a statement for billing errors Negotiate cost reductions with hospitals and clinics Work directly with collection agencies Help find charity programs for assistance. The focus is on the best interest of the patient. We strive to address concerns, improve communication and resolve difficulties-all in a timely manner.

Both the credit reporting agency CRA and the organization that provided the information to the CRA, such as a hospital or collection agency, have responsibilities for correcting inaccurate or incomplete information in your credit report.

Our Patient Advocacy program assists the patient in reporting inaccurate information and provides detailed facts to explain why the item is in dispute and request deletion or correction by the CRA.

A Resource Protective Services' Account Representative will contact the member and validate if they've been balanced billed by the provider. The member will be informed who we are, our process and what billing issues were identified on their claim. We provide our contact information and option to refer calls from providers and collectors to the staff member working on a resolution to their claim with the given provider We assist the member in writing a dispute letter that will be sent to the provider and place the account in dispute.

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A Patient Advocacy Packet is mailed to the member. This Patient Advocacy Packet includes a sample dispute letter detailing the billing issues on their claim and information from the Federal Trade Commission detailing letter detailing their rights when disputing a debt. Claims are further reviewed by our highly skilled RN staff for inappropriate charges.

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