More and more employers with self-funded health plans are turning to reference-based pricing to reduce their overall spend. They like the deep savings, and they appreciate the price predictability regardless of which provider the plan member uses.
Of course, some providers may balk at the reimbursement amount even with a clear Explanation of Payment (EOP).
Thats okay, because HHC Groups bulldogs will bark when they balk.
For all our plans that utilize reference-based pricing services were available to address provider appeals from explanation of payment to direct negotiation. And we support these types of appeals whether we reprice all your clients claims, only hospital claims, only physician claims, out-of-network claims, or specialty services claims.
For more information call 301.963.0762 ext. 163
or email sales@hhcgroup.com