Out-of-Network Billing Specialists

Stop Leaving
OON Revenue
on the Table

Most EMRs handle in-network billing. OON negotiation needs a dedicated layer — REL1EF builds it on top of your existing system to recover up to 6× Medicare rates.

No-Win / No-FeeOON recovery trial — contingency only
Up to 6×
OON Medicare Rate
Negotiated per claim
100%
NSA Compliant
No Surprises Act
50+
EHR Systems
ECW · Athena · any EMR
Medicare OON Potential
25–30%
OON Claims Underpaid
15–40%
Reimbursement Increase
98%+
Clean Claim Rate
50+
EHR Systems Supported
The Problem

Why OON Claims Get Underpaid

Insurance companies use third-party repricing vendors to systematically reduce out-of-network reimbursement. Without active negotiation, providers accept a fraction of what they're owed.

🔻
Automatic Repricing
Payers route OON claims through Zelis, Multiplan, or Viant — vendors designed to reduce your reimbursement to the lowest defensible amount.
EHRs Can't Negotiate
eClinicalWorks, Athenahealth, and most PM systems handle claim submission — not multi-stage payer negotiation, UCR benchmarking, or appeal escalation.
💸
Revenue Left Behind
25–30% of OON claims are underpaid on initial submission. 65% of denials never get reworked. The gap between what you're owed and what you collect grows every month.
⭐ REL1EF's #1 Differentiator

The Dedicated OON
Negotiation Layer

REL1EF doesn't just submit OON claims. We build a specialized negotiation process on top of your existing EHR — challenging every payer offer until maximum reimbursement is achieved.

📊
UCR benchmarking on every claim
🛡️
Zelis, Multiplan & Viant repricing challenged
📈
Fair Health data drives every negotiation
⚖️
IDR / No Surprises Act fully compliant
Start Free OON Recovery
Reimbursement — Same Procedure
Medicare Baseline
Typical In-Network1.1–1.3×
Unmanaged OON0.8–1.2×
REL1EF Negotiated OONUp to 6×
Based on UCR benchmarking & Fair Health data. Results vary by specialty, payer, and geography. NSA-compliant.
🤝
No-Win, No-Fee OON Recovery
We work your aging OON claims on pure contingency. See real dollars recovered before committing to anything.
Start My Free Trial →
Our OON Process

How REL1EF Recovers Your OON Revenue

Five steps. Every claim worked until settlement.

01
OON Claim Identification
Audit your EMR data for underpaid, denied, or unworked out-of-network claims — both current and historical.
02
UCR Benchmarking
Every claim benchmarked against Usual, Customary & Reasonable data, Fair Health rates, and Medicare comparables.
03
Active Payer Negotiation
We engage payers and vendors directly — Zelis, Multiplan, Viant. No initial repricing offer accepted without challenge.
04
Appeals & Escalation
Clinical documentation supports multi-stage appeals. Each escalation step increases recovery probability.
05
Settlement & Reporting
Full settlement documentation with billed vs. recovered by payer and procedure. Weekly reports, full transparency.
Best For

Specialties With the Highest OON Upside

These specialties frequently treat out-of-network patients and have the most room between initial payer offers and negotiated rates.

🚑Emergency Medicine
💉Anesthesiology
🔬Radiology
🫀Cardiology
🦴Orthopedics
🩺General Surgery
🧠Neurology
🧠Behavioral Health
EHR Compatible

Built on Top of Your Existing System

REL1EF's OON layer integrates with 50+ EHR and practice management systems. No migration. No disruption.

eClinicalWorks Athenahealth Epic Cerner / Oracle NextGen AdvancedMD DrChrono Kareo / Tebra Practice Fusion Allscripts ModMed Greenway Health MEDITECH + 37 more
OON Recovery Results

What Practices Say

★★★★★

"REL1EF's OON negotiation team recovered claims we'd written off entirely — same procedures, 3× what we'd been collecting. The dedicated team model changed how we think about billing."

DR
Dr. Richard M.
Cardiologist — Group Practice, Dallas TX
★★★★★

"Our ECW handled in-network fine. REL1EF built the OON layer on top and turned our biggest billing black box into our fastest-growing revenue stream."

MJ
Michael J.
Practice Administrator — Radiology Group
OON Billing FAQ

Out-of-Network
Billing Questions

Everything providers ask about OON negotiation, compliance, and process.

Start Free OON Recovery
Out-of-network billing occurs when a healthcare provider treats patients covered by an insurance plan with which the provider has no contract. Without pre-negotiated rates, claims require active negotiation to maximize reimbursement above what payers initially offer.
REL1EF benchmarks every OON claim against UCR (Usual, Customary, and Reasonable) data and Fair Health rates. We then engage payer vendors like Zelis, Multiplan, and Viant directly, challenging initial offers with clinical documentation and multi-stage appeals until maximum reimbursement is achieved.
Yes. REL1EF's OON billing is fully NSA-compliant. We negotiate reimbursement directly with payers — not patients — and follow all Independent Dispute Resolution (IDR) requirements strictly.
Emergency medicine, anesthesiology, radiology, cardiology, orthopedics, general surgery, neurology, and behavioral health typically see the largest OON reimbursement increases because they frequently treat out-of-network patients.
Yes. REL1EF's OON negotiation layer is built on top of your existing EHR — eClinicalWorks, Athenahealth, Epic, NextGen, and 50+ other systems. No EHR switch required.
Unmanaged OON claims are submitted without active negotiation, typically reimbursed at 0.8–1.2× Medicare. Managed OON claims are actively negotiated using UCR benchmarking and payer engagement, recovering up to 6× Medicare for the same procedure.
Initial claim negotiation typically takes 30–60 days. Appeals and escalations may extend to 90–120 days for complex cases. Most practices see measurable revenue improvement within the first 45 days.
Zelis, Multiplan, and Viant are third-party payer vendors that insurance companies use to reprice out-of-network claims — often dramatically reducing reimbursement. REL1EF's OON team specializes in challenging these repricing decisions to recover fair payment.
Get Started

Start Your Free
OON Recovery Trial

No commitment. No-win, no-fee. We work your aging OON claims on contingency — you see real dollars before deciding anything.

No-win, no-fee OON recovery trial
HIPAA compliant · BAA signed before access
NSA / No Surprises Act compliant
Works with 50+ EHR systems
Request Your Free OON Assessment
🔒 HIPAA compliant · BAA signed before any data access
Revenue Calculator

Revenue Upside Calculator

See how much more your practice could earn with REL1EF handling billing, OON negotiation, and A/R recovery.

6% flat rate — no setup fees, no surprises
OON recovery on contingency — no win, no fee
65% avg recovery rate on aged A/R claims

Revenue Upside Calculator

Select your specialty and billing situation

Your Specialty
Current Billing Situation
Monthly Collections $80,000
Current Billing Cost 6%
Current A/R Over 90 Days $45,000
OON Revenue % 20%
Current Annual Billing Cost
$57,600
Estimated A/R Being Lost
$29,250
Estimated recoverable from aged claims
REL1EF Annual Cost (6%)
$57,600
OON Recovery Upside
$67,200
Estimated additional OON recovery
Your estimated total annual upside with REL1EF
$96,450
Cost savings + A/R recovery + OON negotiation combined
Estimates based on average client results across REL1EF's portfolio. Actual results vary by specialty, payer mix, and claim history. Schedule a free analysis for your exact numbers.
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