Consociate Health > Services > TPA Services > Reference Based Pricing

Reference Based Pricing

Claim review and auditing services for self-funded health plans, for out-of-network claims, or for plans that have decided not to utilize a PPO network for access to providers or facilities.

Consociate Health works with RBP solutions that are set-up to recognize the medical provider’s actual cost of delivering their services and to allow for a fair and acceptable margin above that cost.

Consociate Health only works with RBP solutions that offer effective member advocacy services and provide for plan/member indemnification upon unsuccessful appeals process.

  • 20-40% reduction in annual claim costs
  • Significant reduction in stop loss premiums
  • 2-3% appeals rate (not the member disruption many fear)
  • Cost of convenience — What is is your organization really willing to pay for the sake of convenience? If you could save 20-40% on healthcare claims would it be worth a few members being inconvenienced?
  • ID Card (or is it a blank check?) — Some plans are beginning to view their health plan’s ID card as a blank check. Plan members are accessing high cost providers (even some within PPO Networks). RBP solutions are a means of allowing members access to providers, while ensuring the plan pays a fair and reasonable amount of medical services.

By continuing to use the site, you agree to the use of cookies. Privacy Policy

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close