Reference-Based Pricing – Coming to a Health Plan Near You?

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I think you are going to hear more about reference-based pricing. Some history: What stops a provider from charging whatever they want for care? Let’s say a doctor charges $200 to remove a splinter. If the patient were paying, she/he might try to negotiate the charge or get care elsewhere. But they are most often not. The… [Read More]

Facility Fees: An Alarming Billing Trend That May Cost You

Facility Fees - An Alarming Billing Trend That May Cost You

Get this – an employee decides to see an in-network doctor for a medical issue. At the end of the visit, they pay the applicable office visit copayment. All good? No. Facility fees charged by hospital-owned clinics are a new wrinkle in the reimbursement battle. In addition to the charge for the doctor’s services, patients are… [Read More]

The Frustration of Out-of-Network Billing

The Frustration of Out-of-Network Billing

Do your employees understand all of the implications of receiving out-of-network treatment? Even when a plan provides out-of-network coverage, your employees may find themselves paying out-of-pocket for a lot more than they anticipated. As supervisor of our Benefits Help Desk service one of the most common inquiries or complaints I hear is from upset employees who’ve… [Read More]