Hospital Price Transparency Is a Claims Audit Tool
A hospital now publishes the exact rates it negotiated with your health plan. Most self-funded employers have not opened the file. That is a chance most...
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A hospital now publishes the exact rates it negotiated with your health plan. Most self-funded employers have not opened the file. That is a chance most...
KFF's 2023 Employer Health Benefits Survey found 65% of covered workers are in self-funded plans. Those employers pay claims directly. They buy stop-loss...
There is no fixed statutory price for mental health parity compliance. The cost depends on four factors: how many mental health and substance use disorder...
Pharmacy benefit manager (PBM) transparency determines whether an employer can see what it pays for prescription drugs, how much the PBM keeps, and what a...
The cost difference comes less from the health savings account (HSA) itself and more from the high-deductible health plan (HDHP) that an HSA requires....
For most self-insured employers, maternity and newborn care lands near the top of the annual claims report. It competes with musculoskeletal care, oncology,...
Employer healthcare costs vary more by geography than by industry. A 300-person trucking firm in Birmingham and a 300-person trucking firm in Seattle can...
Most employers that adopt reference-based pricing spend months preparing for provider balance bills. They negotiate hold-harmless language with repricing...
A hospital stay in December. The bill lands in February. The old stop-loss carrier says “no” because the policy ended at midnight on December 31. The...
A company that sponsors a self-funded health plan becomes a fiduciary the moment the plan document is signed. Most employers understand this means watching...
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