Actively Managing Our Cost - A Good Example

Apex Management Group is committed delivering the most competitive products at the most competitive prices.  We could not do this without selecting the right partner organizations that consistently provide "best in class" services to our Apex customer base.  The following is letter from our network provider Multiplan.  The letter addresses how they effectively handled lab claims with their providers during the COVID-19 pandemic.  The bottom line, when MultiPlan saves money on claims, Apex clients save money.

June 2, 2020


As companies around the country slowly start to reopen and we all adjust to a different way of conducting business, one thing that remains the same is MultiPlan’s commitment to helping you reduce healthcare spending while ensuring providers are paid fair and reasonable amounts.

Shortly after the WHO declared COVID-19 a pandemic, we began reaching out to labs that participate in our networks to amend their contracts for specific COVID-19 lab testing reimbursement. We did this to help ensure network providers are reimbursed at levels in line with CMS’s reimbursement guidance and not significantly higher. The first amendments we completed were with two large national labs. We also targeted lab providers from whom we had received COVID-19 lab claims.

I’m pleased to tell you that 50 labs across the country have signed amendments. The reimbursement established for the overwhelming majority of these is 100% of the CMS or MAC rates. For example, one health system would have received over 950% of the CMS/MAC rates for COVID-19 testing, and we amended their contract to reimburse at 100%.

As the crisis continues, we will continue to update our COVID-19 lab claim data and reach out to providers to negotiate their rates.

Joshua Ferro
Senior Account Manager & Sales Consultant

25550 Commercentre Drive, Suite 200
Lake Forest, CA 92630