The patient underwent a simple knee arthroscopy following a fall. The negotiator proposed a settlement based on the state workers compensation fee schedule even though the patient was a non-subscriber to the Texas Workers Compensation program. Following several conversations with the provider, they ultimately signed off on the agreement, saving the client in excess of $21,000 on charges of $24,000.
Patient
Billed
Billed
Paid
Paid
Saved
(63.9% discount)
Saved
(63.9% discount)
The patient suffered spinal injuries following a serious accident while driving from one business meeting to another. He was admitted for 11 days and underwent multiple surgical procedures. In addition to securing a signoff for a cost-plus-based reimbursement for the facility charges, the negotiator was also able to secure agreements for a number of physician fees at a cost lower than the client’s previous vendor who had been handling these expenses.
Patient
Charges
Paid
Saved (60% discount)
The patient was driving in Texas and, following an accident, was treated for severe central stenosis and cord impingement of the C6 & C7 vertebrae following the injury. Originally, he was turned away at the emergency room and referred to a chiropractor, who ordered an MRI and referred the patient back to the hospital due to the seriousness of the condition. During the second admission, he underwent a cervical decompression and fusion with instrumentation. Penfield’s client had previously been made aware of our strong working relationship and discount history with the specific facility in Texas where treatment was rendered. The negotiator reviewed the details of the claim and submitted a proposal and, following a number of detailed conversations with Penfield’s expert negotiator, an agreement was signed for slightly below Medicare reimbursement rates, for both the initial visit as well as the admission and surgery.
