FAIRPAY Solutions offers clients a significant cost containment solution delivering
compelling savings on long term care & extended stay (LTC & ES) bills. FAIRPAY provides substantial,
quantifiable cost containment results on the Per Diem rate and all other services
and supplies provided by LTC & ES providers.
In reviewing and analyzing the financial aspects of a bill, FAIRPAY’s seasoned team
of specialists leverage supply and cost databases and our patent-pending pricing
algorithms as well as our technology platform to achieve total stay savings for
FAIRPAY Solutions is proud to partner with clients to secure maximum savings through
up-front LTC & ES negotiation including those detailed in our savings success stories.
Long Term Care & Extended Stay Treatment at an Acute Care Facility
During FAIRPAY Solutions’ negotiation of this LTC & ES referral, the facility estimated
total monthly charges would be $210,000. FAIRPAY’s experienced specialists obtained
a signed Long Term Care Agreement (LTCA) from the provider for a monthly payment
of $57,000, saving our client $153,000 each month. FAIRPAY’s signed LTCA with this
provider is expected to deliver savings of over $3.6 million for our client during
the estimated two year treatment plan for this patient.
Long Term Care & Extended Stay Treatment for a Burn Patient
In review of the referral for this burn patient’s long term care treatment, the
provider’s monthly billed charges were quoted at $183,000. On behalf of our client,
FAIRPAY Solutions secured an executed LTCA for a monthly payment of $57,000, or
a savings of $126,000 per month. Over the expected two year treatment plan for this
patient, this FAIRPAY Solutions’ client can expect to achieve savings in excess
of $3 million.
LTC & ES Negotiation for National Carrier Lowers Medical Reserves
Recently, a carrier client notified FAIRPAY of a claim in which the injured worker
(IW) was shot during a robbery attempt. Fortunately, after the inpatient hospital
stay, the IW was discharged and experienced full physical recovery without any wound
complications. However, due to the traumatic nature of the injury, the IW was being
treated by a psychiatrist on an outpatient basis. During this time, the IW was diagnosed
with Post Traumatic Stress Disorder (PTSD) and major depression. The MD, communicating with the
adjuster and field nurse case manager (NCM) on the case, wanted to admit the patient
to a 30-day stay at an inpatient treatment center specilizing in PTSD on the claim.
Upon learning of this decision, the carrier referred the case to FAIRPAY for long
term care (LTC & ES) negotiation services. FAIRPAY’s experienced LTC & ES specialists worked
directly with the facility, adjuster and NCM to understand the treatment plan and
prescription. The LTC & ES specialist then engaged the facility in a dialogue focused
on adequate reimbursement for the plan at hand. During this time, FAIRPAY maintained
direct communication with the stakeholders (adjuster and NCM), and worked through
the NCM to obtain additional medical information needed. Meanwhile, the NCM maintained
the relationship with the MD and the patient. When the appropriate treatment reimbursement
was agreed upon by the facility, along with the admission date, FAIRPAY secured
the requisite documentation and distributed copies to the adjuster and NCM. Ultimately
the 30-day stay was extended to 51 days and FAIRPAY was able to save the carrier
$19,695 over the course of the entire treatment stay. Absent FAIRPAY’s involvement,
the carrier would have paid $40,675, but instead only paid $20,980, significantly
lowering their medical reserves.
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