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The Phia Group

Public facts

RBP, OON repricing, plan language, and recovery

Cost-containment firm offering Care Empowered Pricing (RBP), Phia Unwrapped OON repricing, plan-document language, NSA/IDR, subrogation, and PACE fiduciary appeals.

Visit phiagroup.com

Overview

The Phia Group sells a cost-containment ecosystem to TPAs, brokers, stop-loss carriers, and self-funded employers. Named public products include Care Empowered Pricing® (reference-based pricing executed through the Ignite® repricing engine), Phia Unwrapped (out-of-network repricing), PACE® (fiduciary protection on final-level appeals), ICE (B2B compliance), and subrogation/recovery. Phia states it is not a pricing-strategy shop: Ignite implements the TPA or plan sponsor’s chosen methodology (Medicare benchmarks, usual and customary, or other standards). Vendor-stated RBP figures include 20–40% better savings and 2% or less balance billing.

Why it matters Phia is the legal-and-plan-language specialist many TPAs bolt onto RBP; it executes the plan’s methodology instead of selling a single proprietary allowed amount.

Target buyer
TPAs, brokers, stop-loss carriers, and self-funded employers that want RBP/OON execution plus plan language, NSA, and recovery.
Pricing model
Not published; custom professional-services / RBP quote
RBP page cites 20–40% better savings and ≤2% balance billing. Balance Bill Resolution is described as no additional cost with Care Empowered Pricing. No PEPM list.
Availability
National
Research
Last researched 2026-08-23
Public facts category

Key features

  • Care Empowered Pricing RBP with Ignite repricing engine
  • Plan-defined methodology (Medicare, UCR, or other) rather than a single Phia fee schedule
  • Phia Unwrapped out-of-network repricing
  • Balance-bill resolution with independent legal representation (included at no additional cost on the RBP page)
  • No Surprises Act open-negotiation and IDR support
  • Plan document language and compliance (ICE)
  • Subrogation and third-party liability recovery
  • PACE impartial final-level appeals / fiduciary protection

Integrations

  • TPA claims workflows (Phia as execution engine for the plan’s methodology)
  • NSA / IDR process support
  • Direct provider contracts the TPA already holds (named in a Care Empowered Pricing testimonial)

Overview

The Phia Group markets itself as a cost-containment partner for the self-funded community, with buyer pages for TPAs and health plans, brokers, stop-loss carriers, employers, and members. The public ecosystem names Care Empowered Pricing®, Phia Unwrapped, PACE®, ICE, and subrogation/recovery. A Health Plans, Inc. testimonial on the homepage lists third-party liability recovery, regulatory compliance, plan-document development, OON repricing, NSA/IDR support, and RBP support as the services used in that TPA relationship.

Care Empowered Pricing pages state Phia is an execution engine: Ignite calculates, supports, and defends the reimbursement methodology the TPA or plan sponsor defines. Balance-bill resolution is described as included at no additional cost and as covering NSA open negotiations and IDR.

Member phone listed on the public contact notice: 888-986-0080.

Key Capabilities

  • Ignite repricing against the plan’s chosen benchmark.
  • Provider data/selection technology, quality metrics, and access support on the RBP program.
  • Balance-bill negotiation and independent legal representation; published example of a ~$300,000 / 80-line balance settled with more than $120k savings versus the original $300k balance.
  • NSA payment analysis (initial payment, QPA support) and IDR timeline/procedural support.
  • Plan-document language designed to support the cost-containment program.
  • Phia Unwrapped OON repricing.
  • Subrogation, mass-tort, and other recovery (homepage / TPA testimonial).
  • PACE final-level appeals to reduce fiduciary-liability exposure.

Integrations & Ecosystem

Phia is sold into TPA and stop-loss stacks rather than as a stand-alone network. Testimonials describe support for the TPA’s own direct provider contracts. No public EHR or clearinghouse list.

Pricing

Quote-based. The RBP page’s 20–40% savings and ≤2% balance-billing figures are vendor-stated. Balance Bill Resolution is marketed as no additional cost with the RBP program; other modules (Unwrapped, PACE, ICE, recovery) are separate services.

Notes & Limitations

  • Phia does not publish a single national allowed-amount schedule; results depend on the methodology the plan chooses and on provider behavior.
  • Case studies are selected examples.
  • Phia is a vendor/law-adjacent services firm, not a medical insurer.

Sources

Tags: RBP · out-of-network · NSA · subrogation · plan documents · fiduciary