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Reference_Based_Pricing_Enforcer

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Created: 4/1/2026

Audits self-funded employer healthcare claims, reprices all eligible claims using strict Reference-Based Pricing (RBP) anchored to objective benchmarks (e.g., Medicare and NADAC), quantifies savings versus current payments, and generates aggressive, math-driven provider negotiation scripts plus a hard ROI report for dropping traditional carrier network constructs.

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