Reference-based pricing can save payers up to 90% off billed charges. However, some providers don't always accept the repriced amount as payment in full and may pursue your client's plan members for the balance.
That's why HHC Group created a patient advocacy program for our health plans that take advantage of reference-based pricing.
Here's a snapshot of how our advocacy program works for patients who face balance billing disputes from their providers.
- Plan members have direct access to HHC Group's patient advocacy program. They can reach us by phone or email.
- We'll provide plan members with the information they need, including the reference-based reimbursement amount already paid to the provider, so they can negotiate to eliminate the disputed balance.
- As an alternative to self-advocacy, the plan member can unleash HHC Group's bulldogs to negotiate on his or her behalf to reduce the balance due or eliminate it entirely. In these cases, HHC Group earns 33% of the negotiated savings (paid by the plan member).
In addition, HHC Group creates educational materials for plan members describing how their reference-based plan works and giving them instructions on what do do if they are balance billed.