A self-insured employer's incumbent vendor was discounting out-of-network claims at 29%. On the identical $9.11M in billed charges, AMPS delivered 67%, cutting the plan's allowable spend nearly in half.
This self-insured employer had an established NSA program. Their incumbent vendor was processing out-of-network claims and applying discounts against billed charges. On paper, the program was working. Claims were being handled, the plan was compliant, and the reporting looked routine. But routine isn't the same as optimized. The incumbent was settling at a 29% discount against billed charges. A figure that looks reasonable until you ask what was actually achievable on the same claims.
AMPS repriced the identical book of claims: the same $9,111,329 in billed charges, the same providers, the same population. Nothing about the underlying exposure changed. What changed was the strategy applied to it. Rather than process claims through a single discount lane, our in-house team worked each one on its merits: defensible repricing, negotiation-first resolution, and escalation only where it strengthened the position. The result wasn't a marginal improvement. It more than doubled the discount rate.
Billed Charges: $9,111,329 (Identical)
What the switch was worth
A 29% discount looked fine in isolation. Against what the same claims could actually achieve, it was leaving $3.44M on the table.
