Reference-Based Pricing: A Fresh, Cost-Saving Alternative to PPOs

As you start researching your company’s health benefit plan options, don’t discount plans that feature Reference-Based Pricing (RBP).
 
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 Freedom 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.

Why use this type of plan?

• 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.

Reference-Based Pricing Plans are an alternative you need to learn about to make sure you’re spending your health care dollars wisely.

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Allied National

Founded in 1970, Allied is one of the nation's oldest and most experienced third-party administrators. Allied National is a 90 Degree Benefits Company, a subsidiary of Blue Cross Blue Shield of Alabama. As the small group benefit experts, Allied works with small business employers to provide unique and affordable group health benefits.