BCBS Offers RBP Selling Tips

Aug. 10, 2016

Tips for Explaining Reference-based Pricing to ASO Employer Groups

As the selling season gets underway, the following information may help you sell Reference-based Pricing (RBP). RBP is available to 151+ ASO groups.

RBP is a product feature that may help groups save money on employee health care costs.

Here is a simplified example of how the product works:

  • RBP is a benefit maximum — called a “reference price.”
  • Groups can apply these reference prices to some diagnostic procedures.
  • Expenses over the reference price are the member’s responsibility.
  • If the reference price for an MRI is $800, and the member visits a facility that charges $700, the member is responsible for $0 (assuming the deductible has been met or is not applicable).
  • If the member goes to a facility that charges $1,000, the member is responsible for the $200 exceeding the reference price.

We also have tools that provide additional benefit details for members — in order to help them avoid additional out-of-pocket charges. These tools include:

  • Provider Finder®
  • Communication templates that can help groups launch and communicate RBP to their employees
  • Customer Service Advocates who can help members compare costs at different facilities and assist members with the buying decision
  • Benefits Value Advisor, a personalized service that guides members through health care decisions and provides cost estimates for care.

For more information about RBP, contact your Blue Cross and Blue Shield of Texas representative.

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