Hiding fees in claims is a long practiced tradition in American health care finance. Just about everyone seems to be in on the take.
BUCAs can earn part of the PPO discount that’s hidden on the claim side of the ledger. PBMs hide fees the same way. Brokers do too.
An example is that of a South Texas broker who was thought to be earning $127,000 off a school district whose self funded health plan was administered by a BUCA. When we audited the plan’s finances, and dug deep into contracts, the district was surprised to learn there was not one broker they were paying, there were two brokers who were collectively earning $614,000 by hiding extra fees on the claim side of the ledger.
How would you like to know how I can earn $250,000 off a 300 life case with the plan sponsor thinking I’m only earning $30,000 in consulting fees while avoiding the new government disclosure mandates at the same time?