Archive for October 4th, 2011

Health Insurance Claims Paid in 30 Seconds?

Tuesday, October 4th, 2011

When a covered medical service or supply is received

1.

The insured presents the MasterCard® sleeve to the provider’s office.
This “ClaimPay” sleeve contains information similar to a medical identification card. The provider accesses a website listed on the sleeve to submit the claim online.

2.

The website determines, based on the type of services received, the benefit amount payable.

3.

Similar to a pre-paid gift card, in less than 30 seconds the online system automatically loads the benefit amount onto the insured’s plan MasterCard®.

4.

The provider’s office can then swipe the card to receive payment for services, up to the benefit amount stored on the card.

5.

If additional payment is due, the provider can communicate the outstanding balance to the insured.

Editor’s Note: This is part of an email we received today from an insurance company announcing that they can pay claims in 30 seconds. PBM’s have been doing that for years. Medical providers, we feel  sure, would treat this as a CASH TRANSACTION with significant discounts, maybe even better than traditional PPO discounts?

 

 

 

SIIA Conference

Tuesday, October 4th, 2011

Upcoming SIIA Conference will have numerous classes  like the one below:

Tuesday, October 11, 2011, 3:15-4:30 pm

Speaker:

Adam V. Russo, Esq.
Co-Founder and Chief Executive Officer
The Phia Group, LLC

H17: Medical Devices and Other Provider Mark Ups – Challenges and Solutions for Self-Insurers to Better Negotiate Lower Pricing
It has been determined that hospitals and other provider organizations often incorporate huge price mark-ups for medical devices, which inflate health care costs for self-insured employers. Learn more about this mark-up practice and negotiation approaches intended to produce more equitable reimbursement arrangements.

For more information visit www.siia.org