How Reference-Based Pricing Protects Consumers from Overpriced Healthcare

The rising costs of medical care pose a great challenge for employers and employees today. The need for finding a solution to address the concern is thus necessary. RBP is an innovative method that establishes fair pricing of medical services by using Medicare rates. Unlike PPO plans that use negotiated networks, RBP has no network restrictions and pays providers equally. It encourages transparency, reduces out-of-network charges, and empowers consumers.

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Why Reference-Based Pricing (RBP) is a Good Option?

Cost Reduction and Fair Reimbursement–

Significant Cost Savings: Reference-Based Pricing (RBP) reduces healthcare costs by up to 20%, allowing employers and employees to save on medical expenses.

Equitable Payment for Providers: RBP uses Medicare rates to compensate providers fairly, eliminating the need for negotiated network agreements, and ensuring consistency across the board.

Empowering Members through Transparency–

Greater Choice: An RBP allows participants to choose care providers without confinement to a narrow network, enabling them to take more control.

Transparent Healthcare Prices: With rates based on the Medicare fee schedules, RBP would facilitate transparent and understandable healthcare cost presentation for each member.

Optimizing the Use of Technology for Smooth Implementation—

CMS Pricing Tool: The only SaaS-based Medicare claims repricing tool, helping to ease the transition to RBP with a reliable and efficient repricing process.

Cloud-Based Accessibility: CMSPricer is cloud-based, so it does not require complex installations, and easy access is available for claim processing and management.

Conclusion:

The CMS Medicare claims accuracy standards are vital for effective reference-based pricing in healthcare. With a SaaS-based tool, the processing of claims is faster, simpler, and more accurate. Transitioning to reference-based pricing brings transparency and cost savings to employers, members, and providers alike. Learn this innovative solution to streamline your healthcare approach today.