Some RBP vendors are killing it!
In return for $25 pepm law firm will indemnify plan for any unresolved balance bill for amounts exceeding 200% MC.
Hmmmmmmmmmmmmmmmmm……
We know balance billing on RBP plans average 1-2% of claims.
We know the majority of these claims are for less than $2,500.
We know 99.9% can be settled <200% MC.
So why would anyone buy this?
FROM ATTORNEY
I get you were mocking this. The problem with this is the plan will need to pay for it. It will be in plan docs. Providers will get plan docs under ERISA just by asking. They will see indemnification. Then they won’t settle. Dumbest thing I have ever heard of in our space.
Also, if they advertising that providers will know to ask. They are already working together. Kentucky and PA hospitals just sent same letters to members who use them.
If you guarantee payment, providers will not settle at a reasonable price and they have a right to know under ERISA.
FROM PHYSICIAN
This is a scam. The lawyers rarely, if ever, would have to pay anything. This kind of law firm would threaten and probably file any of a number of lawsuits (excessive fees/price gouging, etc.). They may not have much chance of prevailing as a matter of law, but the mere threat of a lawsuit like that will cause the provider to settle for 200% of MC or less. Why would you not? The cost of litigation isn’t worth it, even if you think you can prevail.
