Members judge you on the bill.
Hi Neo locks a member’s out-of-pocket cost for planned, in-network care and holds it through adjudication, so the bill they get is the number you showed them.
Estimates inform. A lock holds
On planned, in-network care, a member can be quoted one out-of-pocket cost and billed another after the claim adjudicates. Each gap can start a chain of contacts: the pre-service call, the call back to double-check, the surprise-bill call, and sometimes an appeal.
Two capabilities. The lock leads.
Out-of-pocket enforcement. A scheduler locks the cost at booking, or a member locks it in your health plan app after seeing real-time deductible and accumulator status. The locked cost is what the member pays for as long as the lock is valid, and one lock covers the whole episode.
Configurable member navigation. Members see, before care, what a service will cost and which in-network providers offer the best value by cost and quality. You configure the messaging and alerts.
1. Lock
At booking, or in your member app before scheduling.
2. Hold
The lock stays valid for a window you set per procedure.
3. Enforce
The locked value is applied before adjudication, through your clai ms platform's own extension points. Your adjudication engine is not reprogrammed.
How a lock plays out.
A member is scheduled for a knee replacement at an in-network hospital. At booking, the scheduler locks her out-of-pocket cost using her real-time deductible and accumulator status. Over the next weeks, facility and surgeon claims arrive. Before each one adjudicates, the locked value is applied, so her bill matches the number she was given.
Start with your own data
Phase one runs on your historical claims, by your analysts, with nothing leaving your environment. It sizes how often a member’s quoted cost differed from what they paid, and why. No integration. No member disruption.
