Our non-network fee schedule is a method of repricing all types of non-network claims that helps clients control plan costs for members who choose non-network providers. We offer this schedule in areas where both network access and choice of providers are optimal.

The non-network fee schedule:

• Delivers real plan savings averaging five to 10 percent by reimbursing non-network claims based on the prevalent network rate in a geographic area.
• Includes geographic-specific price caps for hospital and professional charges to protect negotiated rates from inflation.
• Acts as a strong and equitable financial incentive to channel members into the First Health Network.

We own and control the data used to create the non-network fee schedule, which is automatically applied to all non-PPO claims, enabling quick claims turnaround time.