The Opportunity
Your Clients Are Overpaying.
You Can Prove It.
Self-insured employers are overpaying 15–30% on healthcare and don’t know it. They have their contracted rates. What they don’t have: any way to know if those rates are competitive — because every carrier-aligned repricing tool earns fees on the spread between billed and contracted rates. They have no incentive to flag that the contracted rate itself is above market.
When you bring them data that proves it — and a partner who can fix it — you become indispensable.
$41,000 to $99,000 in recovery opportunities identified from a single utilization report. No claims feed. No BAA required.
How It Works
1
You identify the client
A self-insured or level-funded employer in your book. No minimum size.
2
We do the analysis
They share their utilization report. We benchmark every procedure against market rates, Medicare, and peer employers.
3
Your client saves. You get the credit.
The report goes to your client with your firm’s name on it.
4
You share in the variable fee
On every dollar recovered, we split the variable fee with you. Ongoing.
Value to Your Client / Value to Your Firm
Independent rate benchmarking
Your client sees how their contracted rates compare to peer employers in the same market — from a source with no carrier ties.
Billing error recovery
We find overcharges, upcoding, and adjudication mistakes — and build the case to recover cash or TPA credits.
Co-branded reports
Analysis delivered under your firm’s name alongside ours. Your client knows you found this.
Ongoing revenue share
20–30% of realized savings on every client you refer, ongoing. No minimums — works at 50 employees or 5,000.
First Engagement — 91-Employee Level-Funded Employer (Anonymized)
From a single utilization report — no claims feed, no BAA required — we identified $41,000 to $99,000 in recovery opportunities:
- Cancer treatment with home infusion billed at nearly 3× the plan norm
- Lab cost gap — hospital lab at $113/test vs. $9.57 at preferred alternatives
- Pharmacy utilization with significant unmanaged cost exposure
$455/month. ROI: 2.1× to 3.0×.
Annual engagement fee of $5,460. First finding alone covers two years of fees.
This analysis came from the same aggregate utilization report every broker already receives from the carrier.