Koan Risk Solutions
Koan Risk Solutions is a third-party administrator (TPA) operating in Hawaii. For an ASC, what matters isn't the logo. It's how Koan Risk Solutions pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Koan Risk Solutions analysis
Tell us where to send it. Our team will prepare an analysis of Koan Risk Solutions covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Koan Risk Solutions pays
See how Koan Risk Solutions reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Koan Risk Solutions's presence spans Hawaii. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Koan Risk Solutions and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Koan Risk Solutions's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Koan Risk Solutions up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Koan Risk Solutions
- Payer ID
- 65871 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Koan Risk Solutions through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Koan Risk Solutions members are verified before the date of service, through a clearinghouse using payer ID 65871or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Koan Risk Solutions directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Koan Risk Solutions the way it pays.
- What is Koan Risk Solutions's payer ID?
- Koan Risk Solutions's electronic payer ID is 65871. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Koan Risk Solutions through a clearinghouse.
- How do ASCs verify eligibility for Koan Risk Solutions members?
- Eligibility and benefits for Koan Risk Solutions members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 65871) or through the payer's provider portal.
- Does Koan Risk Solutions require prior authorization for ASC procedures?
- Prior-authorization requirements for Koan Risk Solutions are set per plan and per procedure. Confirm whether an authorization is required with Koan Risk Solutions directly before the date of service.
- What type of payer is Koan Risk Solutions?
- Koan Risk Solutions is a third-party administrator (TPA) operating in Hawaii.
- How does Koan Risk Solutions compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Koan Risk Solutions pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Koan Risk Solutions paying my ASC below market?
- Put your own Koan Risk Solutions contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.