Is healthcare SQUEEZING your budget?
We have the answer, Referenced Based Pricing, and you can save up to 30% off of your healthcare spend.
It's time you take control of your healthcare dollars and to know where, how and how much services cost your members and plan.
Why and What
In your business you must charge a fair price, or customers wouldn’t buy from you and generally, that price is a function of your cost plus a margin. Don’t most business operate that way…….NOT hospitals and medical providers.
The most elusive thing to find in healthcare is a Hospital Charge Master. The bottom line is that hospital charges have very little correlation to the cost or purchasing or providing the services. Many hospitals or providers are charging markups of 500% - 1,000% or move, over what they will accept from Medicare.
COULD YOU GET AWAY WITH THAT?
Advantages of Referenced Based Pricing
No Network Limitation – with RBP programs you can go to any hospital or provider and we can reprice the claim to a fair reimbursement.
Lower Costs – by paying the hospital something that is closer to their cost you save money. We actually see many health plans increase benefits to their employees over time with an RBP Program.
The savings generated can be used to reduce co-pays, improve or maintain current benefit plans and avoid cost shifting health coverage cost increases to their employees.
Long Term Stability – when the cost/reimbursement for healthcare becomes predictable
- Many employers realize a 30% savings under the RBP model and see increases that are significantly below Medical Inflation Trend.
- Gives you complete perspective of how and where your health care dollars are being spent
- Protects you members and plan for over charges
- Dedicated Member Support and Advocacy is only an email or phone call away and we protect your plan and members from balance billing with our partner law firm.
How It Works
The current reimbursement model is based on a percentage of grossly inflated charges. How do we know this? Every provider that accepts Medicare is required to report their actual cost for the services. So, we know what they will accept from Medicare and we know that your health plan is overpaying…. and that is why your costs continue to increase.
Here is what we do to make sure you are paying a fair price:
(1) Review Bill Charges
Review the bill for appropriate charges and reprice the claims to a reasonable mark up above what the provider accepts from Medicare every day.
(2) Fair Reimbursement
We apply the methodology to create a fair reimbursement to the provider that pays for the actual cost of the service plus a significant margin.
(3) Send Claim & Pay Bill
We send the claim to your third-party administrator (TPA) to process and pay the bill.
Ready to cut your healthcare spending?
Contact us now!
Give us a few details about your company and your current balance bill to see how Claim Control Pro can help you cut costs.
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