Lisa’s Plan

  • Cash Pay Community Provider Network includes PCP office visits, Specialist Visits, Radiology, etc. Zero balance billing issues – Providers paid in full through electronic fund transfer at POS
  • Centers of Excellence for Surgical Procedures. Zero balance billing issues
  • Reference Based Pricing for all other services. Plan will attempt to resolve balance billing issues however there is no guarantee those efforts will always be successful

RECENT ANNOUNCEMENT TO PLAN MEMBERS OF A TEXAS POLITICAL SUBDIVISION:

Effective September 1, 2020 The Partnership Plan will be improved to include a new plan option members may choose when seeking medical care.

All patient financial responsibility for covered medical expenses will be waived each time members request plan assistance in selecting high quality medical providers and services.

Surprise medical bills and subsequent balance billing issues are eliminated because Medical providers are paid promptly, in full, by your benefit plan at the time of service.

Members choosing not to use this new plan option will continue to enjoy the same benefits as before, including the same out-of-pocket expenses. However, surprise medical bills and subsequent balance billing issues may occur when providers want more than what the plan allows (Balance Bill).

In those instances the plan will attempt to resolve balance billing issues on behalf of members however there is no guarantee those efforts will always be successful.  In those instances the member bears full financial responsibility. 

RiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.
 
Industry news & updates @ www.RiskManagers.us   

 

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