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Phia Unwrapped - Protection from Costly Out-of-Network and Wrap Claims

A Comprehensive and CARING Out-of-Network Solution

The Phia Group replaces wrap network access and modifies non-network payment methodologies, securing payable amounts based upon fair market parameters with Phia Unwrapped. If any balance bill disputes arise, they are resolved without impacting plan participants.

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Care Empowered Pricing Flyer

Phia Ignite Repricing Engine Technology

With Phia Ignite, we can ensure that defensible claims payments are consistently calculated with pinpoint accuracy, reducing unnecessary risk while maximizing savings for our clients and their self-funded plans.

Our Team

  • Certified Medical Coders
  • Clinical Staff
  • Attorneys
  • Industry Experts

Our Technology

  • Provider Data and Selection Technology
  • Benchmarking
  • All-Encompassing Data
  • Provider Quality Metrics

Phia Ignite gap-filling strategy prices claims where benchmarks and rates aren’t usually available and integrates seamlessly across platforms.

Unwrap My Savings

Resolving Out-of-Network and Balance Billing Claims

The Phia Group combines everything needed to improve your cost containment for self-funded plans while passionately supporting people every step of the way. We resolve balance bills with independent legal representation to ensure that no one is left alone.

Growing savings

Higher
Savings

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Lower
Costs

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Unmatched
Experience

"The Phia Group helps our clients and members in a variety of ways through the Phia Unwrapped product. It helps our clients and members save on out-of-pocket expenses and overall out-of-network expenses related to their healthcare utilization.”

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Jamie Farrell

Chief Business Development & Product Officer
Nova Healthcare Administrators

What You Can Expect with The Phia Group

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Innovative, industry-leading plan language that flawlessly supports the program.

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Maximum savings without member disruption.

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Replacement of unfavorable wrap networks and ambiguous out-of-network pricing.

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Plan language review from the industry experts in compliance.

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No Surprises Act open negotiation and Independent Dispute Resolution process led by attorneys.

The Phia Group is here to protect you against unjust out-of-network claims, wrap claim costs, and balance billing.

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Want to Learn More About Our Other Services?

The Phia Ecosystem

Our services work together—or individually—to help you recognize your full cost containment potential.

ICE

Your Partner for B2B Compliance and Business Solutions

Subrogation & Recovery Services

The Key to Unlocking Your Full Recovery Potential

PACE®

Industry-Renowned Protection Against Fiduciary Liability Arising from Final Level Appeals

Phia Unwrapped

Comprehensive and Technology-Driven Out-of-Network Repricing

Care Empowered Pricing

Next Level Reference-Based Pricing with Quality Care and Fair Pricing Done Your Way

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Partner with The Phia Group for:

  • Compliance Peace of Mind
  • Plan Document Language
  • Claims Issue Resolution
  • Vendor Review
  • Technology-Powered Solutions
  • Access to Legal Expertise
  • Out-of-Network Repricing
  • Maximized Claim Recovery
  • Self-Funded Plan Advice
  • The Highest Level of Care

Unwrapped FAQs

Phia Unwrapped is a way to help protect forward-thinking plan sponsors against unjust out-of-network and wrap claim costs. With Phia Unwrapped, The Phia Group replaces wrap network access and modifies out-of-network payment methodologies, securing payable amounts that are unbeatably low, based upon fair market parameters.

No. Phia Unwrapped replaces traditional out-of-network, wrap, and extender network pricing, regardless of claim size.

The claims flow of Phia Unwrapped is designed to feel exactly like a network. Through an 837 file, The Phia Group ensures accurate claims repricing, which is then returned to the TPA for regular processing.

Yes. For non-network claims, the plan document is the “supreme law of the land” with respect to the plan’s rights, so the plan document must be amended to reflect the plan’s payment methodology. The plan’s ability to defend its payment depends on the rights the plan has given itself.

No. The fee for this service is only a percentage of savings achieved on those claims. There are no hidden fees and no charges for “suggested” but unrealized savings.

Since Phia Unwrapped is designed only for non-contracted claims where the plan does have a primary network structure, there are no concerns regarding compliance. Network adequacy is not an issue for Phia Unwrapped, since users of this service will have dedicated primary networks.
Desiree + Family

Joined The Phia Group in 2006

When Plans Win, So Do Families

We believe that everyone should have access to high-quality and justifiably priced care.

Contact us today to get started.

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