Moved a large client (1100 employees) to Reference Based Pricing 4/1. As I expected, we had some employees who went to providers with the PPO logo removed and some said they don’t take the plan.
SOURCE: Linkedin 14 April 2018
(BTW, for anyone who tells you balance billing is the problem in referenced based pricing I suggest you question their experience.
Balance billing happens LESS in a properly running RBP plan, the bigger issue and more easily solved is the lack of understanding at the front desk when the patient walks in for the first time).
Anyway, I personally called the providers. Here was the conversation paraphrased with all.
Provider: we don’t take that plan
Me: you may be right. Our plan has two requirements. Let me know if you meet them. 1) the doctor must be a licensed Physician. 2) they must accept money as a form of payment. Does your doctor meet both of those? Yes? Super! They take the plan!
Provider: silence
Me: maybe it would help if I told you how we pay?
Provider: yes
Me: do you take Medicare patients?
Provider: yes
Me: super! We will pay you 40% more than what medicare would pay!
Provider: oh, ok… but I still don’t know if we take your plan.
Me: question for you….does your office love dealing Aetna, BCBS, United, Cigna?
Provider: No!
Me: Great! Well here we got rid of them for you!
_________________________________________________
David C. Contorno, President and Chief Executive Officer
david@lakenormanbenefits.com
David C. Contorno is president and CEO of Lake Norman Benefits, Inc. David is a native New Yorker and entered this field at the young age of 14 doing marketing for a major life insurance company. His customer focus, passion for his work, technology experience and performance plunged David into what would become a career of success.
During his 19 years in the insurance business, David has engaged in providing group insurance in various types of markets and industries ranging from manufacturing companies to privately held investment management companies. He has received numerous levels of recognition. To name a few: In 2004, he received a broker spotlight and was recognized by Blue Cross Blue Shield as an outstanding broker of service and in 2005 through 2014, United Healthcare honored him with the Echelon Award reserved for the top 1% of agents nationally. David is a licensed agent in multiple states.
David serves on the Board of Directors for Healthreach Community Clinic. He also serves on the NC Insurance Commissioners Life and Health Agent Advisory Committee, as well as participating in the Technical Advisory Group that helped with the Market Reforms required under the Affordable Care Act in North Carolina. He is an active member in the Lake Norman and Moorseville-South Iredell Chambers of Commerce, and is also a member of the National, North Carolina, New York and Long Island Associations of Health Underwriters. In addition, he enjoys being a part of Rotary International, part of the membership drive for the United Way, assisting the local Habitat for Humanity Chapter, The Dove House Child Advocacy Center and participating in networking functions.
David’s background and visionary experience reflects his commitment to offer the finest access to affordable group benefits to all types of employer groups. When he is not working he enjoys boating, traveling, and being with his wife and their two children, Hannah and Ethan.
