{"id":19534,"date":"2025-03-19T08:58:00","date_gmt":"2025-03-19T12:58:00","guid":{"rendered":"https:\/\/www.napolilaw.com\/?p=19534"},"modified":"2025-03-07T16:09:25","modified_gmt":"2025-03-07T21:09:25","slug":"pricing-algorithms-help-insurers-and-harm-patients","status":"publish","type":"post","link":"https:\/\/napolilaw.lemonadestand.org\/pl\/article\/pricing-algorithms-help-insurers-and-harm-patients\/","title":{"rendered":"Pricing Algorithms Help Insurers and Harm Patients"},"content":{"rendered":"

Are you facing surprise medical bills despite having health insurance? You may be a victim of a little-known practice called out-of-network claim repricing, and a company called MultiPlan may be at the center of it.<\/p>\n\n\n\n

What is MultiPlan and How Does it Work?<\/strong><\/p>\n\n\n\n

MultiPlan is a data analytics company that helps insurance companies reduce their costs for out-of-network billing and medical care. <\/p>\n\n\n\n

While this may sound beneficial on the surface, MultiPlan’s practices often result in patients being unfairly billed for the difference.<\/p>\n\n\n\n

Here’s how it works:<\/strong><\/p>\n\n\n\n

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  1. Providers Charge: When you receive care from an out-of-network provider, they bill your insurance company at their usual rates.<\/li>\n\n\n\n
  2. MultiPlan Reduces Payment: MultiPlan uses its proprietary heathcare algorithms to drastically reduce the amount the insurance company pays to the provider.<\/li>\n\n\n\n
  3. Patients Pay the Price: The provider, not receiving full payment from the insurer, then bills you, the patient, for the remaining balance. This can lead to surprise medical bills that can be financially devastating.<\/li>\n<\/ol>\n\n\n\n
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    \"Pricing<\/figure>\n<\/figure>\n\n\n\n

    The Impact on Patients<\/strong><\/p>\n\n\n\n