OON DIALYSIS

CHALLENGE

  • Member was charged approximately
  • $74,000 each month for OON dialysis
  • Was using an OON facility
  • Laser placed at $800,000

SOLUTION

  • Referred member to case management requesting outreach
  • Team worked to steer member in-network

CLIENT WIN

  • New ID card and education given to member
  • New service implemented to reprice at lower cost
  • Carrier agreed to remove laser

Annual Savings of
$625,000