1 / 3

Cost Plus

Cost Plus. Plan Components. Claim Process. Claim Audit Duplicate Charges Medical Necessity Claim Re-pricing Cost Plus 12% Margin or Medicare + 20% _______________________________________ Frequency 100% Cost ?. Appeals Provider Files Appeal

dobry
Download Presentation

Cost Plus

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Cost Plus Plan Components

  2. Claim Process Claim Audit • Duplicate Charges • Medical Necessity Claim Re-pricing • Cost Plus 12% Margin or • Medicare + 20% _______________________________________ Frequency 100% Cost ? Appeals • Provider Files Appeal • Full & Fair Review By Independent Expert _________________________________________ Frequency 7% Cost ?

  3. Liability Exposure Balance Billing Law firm inserted between patient and provider. ________________________________________ Frequency 50% Cost ? Lawsuits Insurance policy indemnifies the Plan, patient, TPA and broker/consultant ________________________________________ Frequency Low Cost Retention & Premium

More Related