Selecting a medical billing partner, harnessing technology and powerful data
Health plan sponsors need to take strategic action to ensure that their employer-sponsored, self-insured plans incorporate the most effective strategies for addressing today’s economic challenges to the “health and wealth” of their participants. Despite Federal price transparency mandates, a quality health plan should still provide easy, direct access and understanding of pricing, benefits and out-of-pocket expense information so plan participants can make informed and cost-effective decisions.
Innovative medical billing support services utilize powerful data-driven software and online data analytic tools that can provide a degree of price transparency and new insights by harnessing price data electronically – allowing fee comparisons that identity fair and reasonable prices. A tech-driven approach can provide patients with information and tools to better manage their health care costs. Harnessing technology to understand the vast amount of data can identify potential areas of escalating health costs and identify opportunities to control medical spending.
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Cost-management strategies include effectively designed acquisition cost-based pharmacy pricing, HSA-capable coverage, reference-based pricing, adequate participant protections against balance billing, participant advocacy and litigation support.
The right medical billing partner can act as an agent of change, embracing technology innovation and advocating for “what is fair and just.” The right partner will provide value-added services through turnkey solutions, innovative plan designs, administrative and compliance support, as well as participant legal representation. This support provides invaluable guidance to navigate federal and state healthcare regulations, identify areas to lower risk, reduce costs, and maximize value.
About the author: Christine Cooper is the CEO of aequum LLC and the co-managing member of Koehler Fitzgerald LLC, a law firm with a national practice. Christine leads the firm’s health care practice and is dedicated to assisting and defending plans and patients.
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