There is a growing interest in our industry around reducing / negotiating Provider Billed Claims based on some percentage of Medicare, Cost to Charge Ratios, Percentile of U&C or a combination of them. I have thorourghly examined all aspects of this model and have my own thoughts, but would like to hear how the industry is either accepting or rejecting these concepts and why. I will restrain from expressing my opinion until I have seen others comment one way or the other. But I would like to get an idea from others on what they feel the growth of this niche will be, where and when it can or should be used etc…
Editor’s Note: We received this from one of our readers: Most of these guys miss the point. An employer can pay what their plan design designates they pay. The employee can be protected as a part of the plan in the great majority of cases. When the employee can’t be protected it is unlikely that they will have the money to make additional payments anyway and if they manage the process correctly can basically stall collections processes indefinitely. Hospitals are political lighting rods and have to be really careful whom they chase and how aggressively they chase as scrutiny is not on their side.
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