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Wiki Reference-Based Pricing with self-funded plans

Recently there has been a lot of discussion in the self-funded world about Reference-Based Pricing (RBP) and the vendors offering this solution to help these plans save money. The model used in this context advertises an "open network" (go to any provider) then provides the employer with a...
- revtemplates
- Thread
- Apr 30, 2018
- erisa out-of-network rbp reference-based pricing self-funded
- Replies: 0
- Forum: Billing/Reimbursement
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Wiki Out of Network Appeals for ERISA plans

Does anyone have an effective appeal letter which addresses inadequate reimbursement for OON self-funded plans? We have a solid assignment of benefits form, however, we could use some direction with the context of our actual appeal. I understand we have quite a bit of rights under ERISA. If...
- Billing500
- Thread
- Oct 11, 2017
- appeal erisa out of network
- Replies: 6
- Forum: Billing/Reimbursement

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