Preferred Network Access, Inc.

Negotiation Services

PNA has developed a solution to the problem of out-of-network provider claims.

Negotiation of Non-Network Hospital, Outpatient Surgical, Physician, DME, and Prescription Claims

Preferred Network Access, Inc. (PNA) negotiates claims nationwide. Our negotiators will review each claim prior to any negotiation and determine the viability of discounting the claim. Once the negotiator has reviewed the claim, they will use PNA's proprietary database to achieve the best possible discount. Negotiation parameters are customized for each client.

2010 Savings

Claim Type	# of Claims	Billed	Savings Percentage
Dialysis	271	$3,679,432.05	67%
Out-Patient Surgery	138	$1,513,930.26	52%
Infusion Therapy	10	$218,760.00	85%
Hospital	124	$2,442,220.42	37%
Physician	623	$1,734,174.37	33%

2010 Total Savings

1,856 Claims - $11,186,839 Billed Charges - 49% Savings

Suggested Criteria:

All Prospective Non-Network Inpatient and Outpatient Admissions
Hospital Claims $500 and over
Physician Claims $500 and over
Ancillary Provider Claims $500 and over
DME Provider Claims $500 and over
Prescription Drug Provider Claims $500 and over
Criteria can be customized by client

Procedure

PNA will verify with Payor:

Eligibility of patient.
Procedure is a covered benefit under Plan.
Charges are not above Reasonable and Customary.
Claim can be paid within 10 or 15 business days.

After criteria are met, PNA will commence negotiation with Provider.

Negotiations are usually completed within five business days.

Provider contractually agrees in writing to the negotiated discount.

Repricing Cover Sheet and claim are faxed or sent electronically to Payor.