After spending 5 years working for one of the leading national dialysis providers where he was the national director of collections and appeal litigation for out-of-network operations, our founder started DialysisPPO in 2006, bringing a new and unique approach to the payer side of this market.

Previously, health Plan options for managing dialysis costs were limited to accepting minimal PPO network negotiated discounts or pursuing the risky strategy of paying based on some “usual and customary” basis and hoping the provider didn’t take legal action. We take a different approach. We work with self-funded employer group health Plans and their service partners to implement changes to their Plan document that capitalize on the unique reimbursement aspects of dialysis care in American healthcare.

As the only medical diagnosis that qualifies a patient for Medicare entitlement, regardless of age, creative reimbursement strategies and techniques are almost universally overlooked by Plans. Our program entails an administratively simple modification of the Plan document establishing two new benefit instruments that in combination enable Plans to reduce their dialysis costs by up to 80% after only 3 months of dialysis services. Our typical client’s dialysis cost savings is $590,000 per case annually.