Before we started costpluswellness.com, we went to hospitals and providers of all sizes and asked them what their pain points are. What cost them money, what created operational friction and impacted their ability to serve patients. The responses were always the same. The Insurance companies and the administrative services organizations they own or operate created problems at multiple levels.
The problems insurers create
The first problem was that the carrier defined plan deductibles as exclusively the provider's responsibility. Who took on all the credit risk. Literally, having to loan the patient money and becoming sub-prime lenders, at a substantial cost. Then, despite having negotiated contracts with very specific terms, they more often than not underpaid the contracted amount using any angle or excuse they couldcome up with .
Then, they late paid. They clawed back fees. Introduced time consuming and costly audits, and as we all know, they would deny claims, leading to peer to peer calls between your doctors, and people who literally would not identify themselves or provide any credentials. Their only mission was to delay paying for critical care as long as they could. Taken all together, providers were required to hire untold number of administrative and legal employees, with the associated overhead and benefits burden for each.
They made serving patients far more expensive. If serviing patients is more expensive for providers, it will be even more expensive for Employers and their members.
Our offer to providers
Seeing this, Mark Cuban Companies reached out to providers with an offer. For our members, we want to create a direct contract where :
- We pay the contracted amount within 30 days
- We will take on the employee out of pocket responsibility. You will not face that credit risk.
- We will trust our doctors. We will first do quality checks. We will constantly review and evalue them. But we will trust them. There will be no denials of claims. Any intervention will happen prior to reaching the provider.
What you get in return
Employers using these contracts will receive better pricing than available through carriers, and the ability to publish these contracts and prices, here on costpluswellness.com
The goal is that we will bring providers more direct contracting business as employers as the employers see the benefits and cost savings. More direct contracting business not only means new patients, it means higher yields. Much higher yields for you
Get started
We strongly encourage you to review the contracts posted and to post your contracts, to drive more profitable business.