Lawmakers to Address Medical Bill Sticker Shock

By Danielle Leigh, KING Washingtonians complain they’ve been caught off guard by exorbitant medical bills despite having health insurance. The sticker shock comes from a practice known as balance billing. Balance billing happens when medical providers such as doctors and insuran
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PhilHealth No Balance Billing Policy

The Daily Guardian The No Balance Billing (NBB) is a new PhilHealth policy mandating that no other fees shall be charged or paid for by the PhilHealth patients who availed of any of the identified 22 medical and surgical cases under the case rates package payment scheme. This NBB poli
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Secrets to Making Reference-based Pricing Work

MyHealthGuide Source: Adam Russo, Esq.,1/14/2016, Thompson Information Services Blog In order for reference-based pricing (RBP) to work, health plan sponsors should do it in a way that involves implementing best practices for cost analysis, claim repricing, plan design, patient advoca
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Four Reasons Why Reference Based Pricing Could Become the Norm for Self-Insured Employer Groups

AmWINS Group, Inc. As self-insured employer groups wrestle with the requirements of the Affordable Care Act (ACA), some are tapping the potential of reference based pricing (RBP) to control costs. Expect this trend to become more common among larger self insureds, especially as proof
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Reference-based health care reimbursements require careful application

Joanne Wojcik PHOENIX — Reference-based pricing could trigger balance-billing by providers if employers do not implement this cost-containment tool carefully, experts warn. Read more…
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The pain of out-of-network claims

Article Written By: Shana Sweeney  Taken From: Employee Benefit News Lately, I’ve been reminded of a great video from three years ago called ‘If Air Travel Worked Like Health Care’. Recently, I’ve had an influx of employees at my desk with stacks of bills and e
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ENQUIRER EXCLUSIVE: Insurance plan pits hospitals vs. employers

A standoff over a new health care plan just being introduced here has some workers facing the threat of new medical bills. At least nine local employers with more than 5,000 employees already have signed up for the new plan, called TrueCost. Read More..
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