The Great Money Grab

Be Afraid, Very Afraid

By Molly Mulebriar

“You don’t want me to know your business because it won’t be good for you” said the physician group’s business manager some years ago.

This was a referral prospect who was interested in learning more about Reference Based Pricing as an alternative to their Aetna health plan.

She had done her homework. It became quickly apparent our broker friend was not the first to meet with her to discuss Reference Based Pricing strategies. He quickly understood she was shopping brokers and he was only one of many coming through the revolving doors.

“Paying fees based on a percentage of gross billed charges is not something we will ever agree to do. We had one vendor here wanting 12% of gross billed charges and 6% on established direct contracts. When we asked if commissions were paid on that and how much we didn’t get an answer. So we won’t do business with him. What about you?” she asked.

She was a very smart business manager. She may be surprised to know that a legacy RBP vendor has since upped broker compensation from $8 pepm to $16. That’s caused a huge money grab stampede within the brokerage community. Other RBP vendors have begun to offer higher commissions too in order to maintain their broker base.

Now with the broker disclosure rules to be effective 27 December 2021, fees and commissions must be disclosed. Brokers earning the heretofore undisclosed big bucks should be afraid, very afraid.

We are already getting tips from our sources exposing hidden commissions and fees earned by brokers. We received an astounding TPA Administrative Agreement today that will curl your toenails.

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