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Another Medical Bill? Surprise!

3/24/2020 10:03:58 AM

If you’ve ever been to the emergency room or had a surgery, you likely know that the bill you get from the hospital isn’t the only bill you’re going to receive. Soon, you may receive a bill from the doctor (or doctors) you saw. What happens if one or more of these providers are not in your network? Now you know what surprise billing is. Read More>>


We want to assure our broker partners, clients and members that we are committed and prepared to support those we serve throughout the COVID-19 situation. As part of this commitment, we are sharing information about COVID-19, details about member access to medical care, and insight into our business continuity planning. Read more>>


Healthcare news these days frequently features articles or a quote from an industry “expert” relating to drug costs. They emphatically declare that pharmaceutical costs in general are spiraling out of control. But is this really the case? Martino Luu, EVP and General Manager of HealthSmartRx, says this may not necessarily be accurate. Read more>>


There was quite a stir in the healthcare industry – and to our clients – when HHS released a proposed rule aimed at eliminating rebates from pharmaceutical companies to PBMs in Medicare Part D and in Medicaid managed care organizations. Will manufacturers unilaterally lower the list prices? What’s the impact on premiums? More>>


Recent legislative events are taking aim at price transparency, including an executive order by President Trump on healthcare price transparency. Read our guest blog by our partners, Healthcare Bluebook, for their take on the recent healthcare price transparency regulatory action.
 


What happens when an employee receives a bad call about their health? If they find out they have a serious – even catastrophic – health condition, how does an employer with a self-funded plan manage this?


With the anticipated growth of healthcare costs and the high costs paid to hospitals by health plans, it becomes a real challenge to “bend” healthcare costs downward.


How leveraging coupons and copay cards can save some serious money.
By Peter Beerman, Senior Vice President, HealthSmartRx Solutions
 


A look at some of our successes over the past year along with some insights into 2019 by our CEO, Phil Christianson.


What happens if an employee's health plan doesn't have negotiated pricing with their hospital? Unless the patient and plan pay the full price amount for services, they could find themselves in litigation. As more small and mid-size companies opt to self-insure, finding a way to better control the cost of facility and hospital expenses has proven Reference Based Pricing (RBP) to be a smart solution.


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