March 2021 | Get the latest from the best RBP advocates and auditors
Industry Perpectives
Andy Orear
Vice President of Distribution
6 Questions About Making the Switch to Reference Based Pricing
Healthcare costs continue to increase annually at a rate far above the national cost of living percentage. Health insurance is one of the largest expenses in a companies’ budget, and after years of providing health benefits, many employers are struggling to keep their employees covered. Reference based pricing (RBP) provides a way to continue insurance coverage while reducing expenses by setting the prices paid to physicians and hospitals at a more reasonable rate.
What is RBP
Reference based pricing is not an insurance plan; it is a financing strategy that works with the employer-sponsored insurance plans to accomplish these four goals:
Reduce costs
Provide more freedom in selecting physicians and facilities, removing network limitations
Give employers control over physician and facility charges by setting payment amounts
Provide a long-term sustainable trajectory for the employer and employee
Comprehensive line-by-line claim auditing by healthcare professionals is used to uncover errors typically not caught. ClaimDOC publishes a sample of five recent client savings audit results bi-monthly. See the savings below and know that together we can make healthcare affordable.
1. Stockton, CA
Four-day hospital stay for the treatment of osteomyelitis of the low back
High-Dollar Services:
Room and Board: $29,816 MRI - Spinal Cord: $26,067
Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies, and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.
Member Experience
Feedback from an Employer
I want everyone to know how much I appreciate my member advocate Britany for taking the time to write informative and helpful emails to our employees. As you can imagine, the after surgery bill surge can be confusing and scary. It's a relief to know our employees have ClaimDOC fighting for them and reviewing their bills. Brittany's efforts make our days a little bit brighter. Thank you for your hard work! It is appreciated
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Whether you're an Employer, Provider, Broker, Stop Loss Carrier, or Member, get valuable information 24/7 by visiting claim-doc.com.
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