NSA – The Nightmares Continue
The healthcare cost savings promised by the No Surprises Act still haven’t materialized. This is despite another year of data, more implementation experience and additional…
Resources
Audit Reduces Member’s Cost by $9K, Saves Plan Nearly $31K
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and…
How Dual Option Turned an RBP Skeptic Into an Advocate
Convincing consultants to bring reference‑based pricing to clients isn’t easy. Paul Saunders, executive vice president at Saunders & Company, knows firsthand as someone who…
Audit Saves Plan Over $32K After Member’s Heart Attack
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and…
Same Colonoscopy, Different Facilities, Wildly Different Costs
More than 16 million colonoscopies are performed in the United States each year. A common gastrointestinal procedure, colonoscopies are routinely performed as a screening for…
Good TPAs – They Do Exist
Who’s a good third-party administrator? There are many to choose from, but far fewer that consistently deliver when it matters. And the difference between…
Member Saves $10K After Complicated Childbirth
With DirectAccess+, clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and…
Looking Back and Looking Forward
Review of 2025 I really look forward to writing this article each year. Who you trust your health plan with is a huge decision, and…
The Search for a Good TPA — Part 2
Selecting the right vendors for a reference-based pricing health plan isn’t an exact science. At the end of the day, it often comes down…