Repricing alone doesn’t stop aggressive billing, inflated charges or balance billing exposure. In a market where high-cost claims are growing in frequency, size and complexity, benefits advisors need smarter tools, and partners, to deliver measurable results for self-insured clients and stop-loss carriers.

This discussion will challenge outdated assumptions about network discounts, explain where cost containment strategies typically fall short and equip advisors with actionable insights to evaluate vendor performance and spot red flags. This session will walk attendees through real-world claim scenarios where repricing left money on the table, and document how layered clinical, legal and financial review can drastically shift outcomes. It will also outline how TPAs and brokers can respond when provider power plays, such as upcoding, DRG misalignment, improper modifiers and inflated out-of-network charges, go unchecked by automated repricing systems.