At the Private Employer Roundtable on April 11, Regional Sales Director Brooke Hupp highlighted alternative reimbursement strategies that reduce health care costs, including MedBen’s newest strategy, Fair Market Reimbursement (FMR). This innovative approach maximizes savings by comparing claims across the country while minimizing noise by supporting payment recommendations with comparable claims data.
Rather than just using Medicare as a pricing benchmark, “Fair Market Reimbursement looks at geographic information and millions of claims, using algorithms based on hospital claims information,” Hupp said. “It’s a more defensible way for claims to be paid.”
As the chart below shows, employers who make claim payments based on FMR realize substantially lower costs across different types of service.
“Since 2021, FMR has saved self-funded employers an average of 69% on their claim costs,” Hupp noted. “In 2023 alone, the average per-claim savings was 71%.”
Should a provider question a payment, it can be readily defended and, when appropriate, negotiated. The average appeals rate in 2023 was only 0.35%, with a 100% resolution rate… and in every case, settled for the original reimbursement amount.
You can get additional information about Fair Marketing Reimbursement by visiting MedBen,com… or just contact your broker or call MedBen at 888-627-8683.