Renegotiating Clinic Contract Terms Nets Refund, Greater ROI

Client

A public sector, government client with more than 215 employees and 225 total covered lives.

Challenge

The Township’s leaders had negotiated a clinic arrangement through its benefits plan as ease of access to care was a priority for its employees. However, when compared to Apex’s book of business, it was determined the client was paying a considerably higher dollar amount than it should.

“Offering our employees easy access to routine medical care has always been important for us, which is why we chose to invest in a near-site clinic,” said the Township’s Fire Chief.

The Township’s leaders had negotiated a clinic arrangement through its benefits plan as ease of access to care was a priority for its employees. However, when compared to Apex’s book of business, it was determined the client was paying a considerably higher dollar amount than it should. “Offering our employees easy access to routine medical care has always been important for us, which is why we chose to invest in a near-site clinic,” said the Township’s Fire Chief.

Solution

Kinetiq Health’s in-house financial and clinical analysis team was able to use its expertise and knowledge to identify areas of opportunity within the clinic contract to allow a greater financial return for the client. The team did this by reviewing the client’s current and previous contracts with the clinic, along with monthly invoices, to identify areas of potential savings or overpayment.

Results

It was determined that the client was due a refund. The Township not only saved money, but also saw an improved return on their investment for the clinic.

The savings understandably left the client pleased knowing it was spending less per year for the same services.

After three years, the client was able to realize savings of more than $505,000 on its clinic.

“Not only do we feel like we have the best new contract in place for our organization, Apex was also able to find errors in billing which resulted in a significant refund being issued back to us,” the Chief said. “We feel like the working relationship has only grown stronger with our clinic partner throughout this tedious process. We are all on the same page and feel like we are headed in the right direction with little to no disruption being seen by our employees.”

Case Study

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