Don’t be stuck with Out-of-Network retail prices
Most self-funded plans use Active PPO programs for employees, typically
incentivizing employees to utilize the services of an in-network
PPO provider in order to take advantage of the discounts that PPOs
offer. What happens, though, when an employee or family member go
to a non-PPO provider? Generally, employers are stuck paying retail
prices for such services.
Cypress Benefit Administrators gives employers access to provider
discounts even when the plan doesn’t offer a PPO or when employees
choose to go to an out-of-network physician or hospital through
its Passive PPO arrangements.
In addition, Cypress will negotiate discounts with providers where
none exist, assuring that employers pay the lowest available rate
for any and all providers.
PASSIVE PPOs
- Access to over 650,000 providers and 140+ PPOs nationwide;
- Discounts achieved on 72% of all retail claims;
- 26% average discount on Passive PPO claims;
- No minimum dollar threshold.
PROVIDER R&C NEGOTIATIONS
- Medicare cost-to-charge data establishes baseline for reasonable,
not provider charge;
- Negotiate from net cost up rather than billed charge down;
- 85% success rate – savings ranging from 18% - 34%;
- Not a prompt pay discount program.
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