A few weeks ago, I shared an analysis we developed at Vericred that explored the accuracy with which hospital websites disclose the health plans where they participate in-network. The results were very revealing, so we decided to extend that analysis to examine the quality of Machine Readable Directories (“MRDs”) mandated by CMS for plans … Continued
Nearly 70% of Hospital Websites analyzed missed the mark. A rule issued with much fanfare by the Department of Health and Human Services now requires that hospitals make their “chargemaster” public via the internet effective January 1st, 2019. The chargemaster is a list detailing the official rate or list prices charged by a hospital for individual procedures, services, … Continued
When it comes to health insurance provider networks, our typical impulse – whether we’re a broker, a benefits administrator, or an individual shopping for insurance – is to operate under the assumption that “bigger is better.” In some ways, this sort of gut feeling is hard to argue with. After all, “bigger” means more providers … Continued
The other day, I was in the car when I heard a commercial for a bariatric clinic offering lap-band surgery. The commercial ended with these words: “…your PPO insurance should pay.” This might lead someone to believe that their insurance would cover the entire procedure. It. Does. Not. This is by no means the only … Continued