Rather than using a Preferred Provider Organization (PPO) network for claims discounts and pricing, RBP plans use some other method on which to base medical claim reimbursements to providers.
Many plans, like Allied National’s RBP plans, use Medicare for its reference base. We reimburse physicians 125% of Medicare allowable and facilities at 150% of Medicare. This reimbursement level is often lower than many PPO networks but is still well above Medicare levels accepted by most providers. These savings immediately translate to lower premiums and lower out of pocket costs when you need care.
- Freedom – The ability to go to any provider without fear of “out-of-network” penalties. There is NO network!
- Premium savings – Depending on your region of the country, premiums using the RBP plans can be anywhere from 10-30% lower than a typical PPO network plan
- Acceptance –RBP plans are becoming more common and are widely accepted by providers…so are the reimbursement levels.
RBP plans are an alternative you need to learn about to make sure you’re spending your health care dollars wisely.
Author: Timothy Shrout
Tim is a 25-year group benefits veteran and the sales and marketing associate director for Allied Direct, a division of Allied National.