WellRithms Publishes Groundbreaking White Paper: The Wait is Over – Guaranteed Protection from Balance Billing
Source: WellRithms, 5/9/2024
PORTLAND, OR – WellRithms, the industry leading payment integrity firm, released a white paper revealing the ongoing challenges of healthcare balance billing and introducing a revolutionary captive solution to shield plan sponsors and members from financial liability. “The Wait is Over: Guaranteed Protection from Balance Billing” presents a first-of-its-kind captive insurance for group health and workers’ compensation plans designed to transfer the risk exposure for excessive claims away from payors and members.
“WellRithms’ Shield Indemnification™ sets in place a legally defensible strategy to reprice individual medical bills and fully absorb that risk,” says Ira Weintraub, M.D., WellRithms’ chief medical officer. “Readers will learn the value of guaranteed protection from balance billing, relieving payors and patients from the clutches of collection agencies and relentless harassment.”
While captives have long been used for managing risk in various industries, traditional captives do not effectively manage the risk of individual medical bills, leaving payors and patients vulnerable to balance billing. Attempts at indemnification against egregious billing practices, such as Contractor Liability Insurance Programs (CLIPs) and reference-based pricing (RBP), fall short in protecting payors and members from financial liability.
“WellRithms substantially raises the bar on precision by layering Shield Indemnification™ on top of our proprietary repricing system, Sustainable Claims Pricing™,” continues Dr. Weintraub. “This methodology ensures claims payment accuracy by repricing medical bills based upon various factors, including hospital cost-to-charge ratios, geographical cost variations and inflationary adjustments.”
WellRithms is the only payment integrity solution that successfully tackles the ongoing tug of war between payors and providers, extracting patients from the crosshairs of provider attempts to increase reimbursements for medical services, ensuring that providers have been paid appropriately.
Download the white paper here.
About WellRithms
WellRithms saves money for health plan sponsors by Leveling the Paying Field™ between healthcare purchasers and providers. The company serves group health and workers’ compensation payors who seek the most advanced medical bill review system available, the most precise repricing, and unsurpassed plan savings. WellRithms Shield Indemnification™, backed by our insurance captive AMI Indemnity, sets WellRithms apart by transferring full financial liability from the payor and participant to WellRithms, rendering balance billing tactics, collections, and pressures to overpay ineffective and unenforceable. Visit wellrithms.com.
