claim-allowable or negotiated-discount rates

Noting that as much as $3.2 trillion a year in medical care is “secretly priced,” an entrepreneurial physician named Bill Hennessey is on a mission to unmask those costs for self-insured employers with the help of brokers and advisers. The secret weapon: an ability to identify by ZIP code known charges and claim allowables before services are actually rendered. The proprietary platform, Pratter, instantly identifies, itemizes and targets a host of outpatient procedures, seeks to break the confounding cycle of contractual arrangements with TPAs or insurance carriers that prevent employers from auditing their own claims...

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