NEVER FEAR THE BALANCE BILL
â–
MEGAN FREEDMAN
10
Never Fear the Balance Bill THE KEYS TO A SUCCESSFUL REFERENCE BASED PRICING MODEL By Megan Freedman
Many self-funded employers in the U.S. are intrigued by the idea of the free market movement but have not attempted to implement any direct contracts with free market friendly physicians and surgery centers. There are many reasons for this hesitation, including the belief that a carrier is the only viable TPA option, or that network discounts will save them money. However, many employers believe that the only way to be able to direct contract is to not have a network at all. Often, these employers are uncomfortable with the idea of their employees facing possible balance billing. Rental networks that will allow an employer to direct contract do exist, but they may not be available in the employer’s area or are not the solution the employer desires. Luckily, there are new out-of-the box solutions and vendors that can help ease this transition non-traditional reimbursement strategies work effectively, while reducing balance billing concerns. 10
ShopHealth | Vol. 2 | Issue 3
