Cost Plus Methodology for Medical Claims Pricing


Utilizing our cost-plus methodology we produce superior savings for our clients by leveraging real cost and quality data mined with our own unique algorithm.

PayerFusion provides true cost containment for payers by basing our medical claims pricing on the actual cost of appropriate care, not a percentage reduction off of an inflated retail price. Our negotiations with providers are based on a clear understanding of their costs – by type and size of facility, type of treatment and by actual share of unfunded or underfunded care that requires them to cost shift. This knowledge empowers us and our clients, with a unique advantage in negotiating fair reimbursement for quality care.

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