THE SOLUTION
TO YOUR
OUT-OF-NETWORK
CLAIMS PROBLEM
THE CHALLENGE YOU FACE

Large insurers and third party payers have invested millions of dollars to minimize the amount they pay healthcare providers by creating loopholes and introducing new strategies, thereby effectively reducing reimbursements to Medicare levels.

$24,000

Billed

100%
$16,080

Settled

67%
-$7,920
Loss to health care provider.
Actual results of a self-negotiated out-of-network claims settlement.

Large insurers and third party payers have invested millions of dollars to minimize the amount they pay healthcare providers by creating loopholes and introducing new strategies, thereby effectively reducing reimbursements to Medicare levels.

$24,000
Billed0%
$16,080
Settled0%
-$7,920
Loss to health care provider.
Actual results of a self-negotiated out-of-network claims settlement.
HOW OPES WILL HELP
$24,000

Billed

100%
$22,435

Settled

93.5%
+$4,205
Increase to healthcare provider after OPES fees.
Actual results of a self-negotiated out-of-network claims settlement.

We are familiar with the tactics and strategies that are being used against healthcare providers. Our intimate knowledge of their methods makes us an incredibly effective ally for any healthcare provider.

$24,000
Billed0%
$22,435
Settled0%
+$4,205
Increase to healthcare provider after OPES fees.
Actual results of a self-negotiated out-of-network claims settlement.

We are familiar with the tactics and strategies that are being used against healthcare providers. Our intimate knowledge of their methods makes us an incredibly effective ally for any healthcare provider.

How We Work for You

Initial Offer

OPES Group gets involved as soon as a settlement is offered from the insurance provider. Even on Medicare-based policies, a successful negotiation is attainable.

Negotiations

Change the entire paragraph to this: Since the initial offer from the carrier is almost certain to be too low, OPES will continue to use our proprietary software and years of experience until a mutual agreement has been reached

Persistent Negotiations

Negotiations will sometimes appear to grind to a halt. OPES Group consistently increases claim value beyond this point because we know what you're entitled to, and when an Insurance Provider is withholding a larger payout.

Maximum Settlement

Because we accurately know the value of your out-of-network claim before the billing process is started, OPES Group achieves maximum settlement every time.

MRC2 Policy Example
$16,500

Billed Charge

100%
$3,090

First Offer

18.73%
$9,900

Second Offer

60%
$9,900

Third Offer

60%
$10,498

Fourth, Accepted Offer

63.62%
What Makes Opes Better

Professional Negotiators

Our teams have been through exhaustive training specifically tailored to the medical claim industry.

Proprietary Software

Opes RX Group has proprietary software that uses complex databases and algorithms to help track, monitor, and analyze each claim to determine the most effective negotiation strategy.

Unique Experience

Our team members have experience on both sides of the negotiation process. We understand the strategies that large insurers employ to reduce claim level reimbursements. This knowledge combined with our internal processes achieve satisfactory results.
Client Success:
See how much OPES can earn you!
Use our Claims Calculator to estimate the value of your claim,