Moving away from managed care contracts can be fraught with nightmares of ruined credit. No one wants to be classifed as a deadbeat and go to court. What say you, Bill OReilly?
Try selling a Cost Plus Insurance plan to an HR director! You will get nowhere fast. The threat of balance billing works almost every time, scaring and immobilizing plan sponsors into submission. It is a potent and effective weapon providers and their PPO partners use with great effectiveness. Afterall, the only thing that matters to most HR directors is that managed care contracts deliver the promise of no balance billing. To these mental giants, costs are secondary to employee demands driven by OPM (other people’s money) syndrome.
There are strategies to be employed to protect consumers from balance billing issues. Some are rather aggressive (and costly to administer), while others are less aggressive, fair and balanced, but equally effective (and less costly to administer).
We know of three TPA’s who have successfully combated the balance billing dilemma utilizing a less aggressive approach than others in the industry, at far less administrative costs to their clients. We note two below:
PayerFusion – We Guarantee Zero Balance Billing
At PayerFusion a paid claim is a closed claim. Our methodology and claims management services eliminate any possibility of balance billing- guaranteed. Our clients are our partners; together we fuse the gap between providers who deserve fair compensation and payers who seek fair prices for services rendered. We also utilize our own provider network, PayFuseNet. It is not a PPO. We guarantee zero balance billing to our clients as part of our comprehensive medical claim administration services, guaranteeing that patients will never be hassled by a provider for additional funds. For more information on our medical claims management services visit our services.
2. Allied National
Allow your clients the full choice of health care providers without restrictions or penalties. There are no preferred providers or networks required. They see the provider they choose!
|Your clients will still receive the value of PPO-like discounts with protection from balanced billing for all medical services.