Facts, Working Process and Benefits of Opting for Medicare Reference Based Pricing

1. Facts, Working Process and Benefits of Opting for Medicare Reference Based Pricing Healthcare reference-based pricing begins with a benchmark or reference price rather than a discount off of billed charges, as traditional networks do when pricing claims. Usual and customary pricing are examples of traditional pricing strategies. A reasonable price for medical services is determined by reference-based pricing, such as the Value-Driven Health Plan services and a PPS pricer offered by the best organization, CMSPricer, a MultiPlan company, based on Medicare and cost data. Reference-based pricing is required when a claim is priced using Medicare pricing and other benchmark pricing methods. Before the services are rendered, it is sometimes possible to negotiate reimbursement for such claims with the provider. Employers can use reference-based pricing services to replace reference-based pricing services to employees in conjunction with a traditional PPO network for practitioner and ancillary services. reference-based pricing frequently encourage usage "with or without a network." a traditional PPO network or offer Consequently, services that use What Advantages Does Reference-Based Pricing Offer? Services that use reference-based pricing often use terms like "transparency," which means the patient can get a good idea of how much they will pay for care by using a specific reference price, like the amount Medicare would pay for a procedure and also a percentage of that Medicare price. Leading reference-based pricing companies like CMSPricer, a MultiPlan company, use tools like websites and smartphone apps to give members access to information like an estimated cost, how much a member would pay compared to another, and how

2. satisfied other patients were with a provider's quality of care. Members can make an informed choice about where and from whom they would like to receive care if they have access to this information. Medicare reference-based pricing services can supplement or replace an employer's current PPO network. Why? "Transparency" is the key word for employers. The employer might save money by using pricing based on references.