No Surprises Act Resource Center
Transparency in Medical Billing.The No Surprises Act and Transparency in Coverage rules (NSA) protect patients against financial burdens that arise from unexpected medical bills, including bills from:
- Emergency care;
- Non-emergency care from out-of-network providers at in-network facilities; and
- Air ambulance services from out-of-network providers.
This Resource Center provides access to NSA information and transparency tools. MedBen will regularly update this page as more materials become available.
MedBen clients with questions regarding NSA rules are welcome to contact our Compliance Department.
Your Rights and Protections Against Surprise Medical Bills
When you get Emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. This document outlines your rights and protections against these bills.
This portal offers machine readable files that are made available in response to the federal Transparency in Coverage (TiC) Rule and includes negotiated services rates and out-of-network allowed amounts between health plans and health care providers.
The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. The data is NOT intended for use by individual employers or plan members.
Self-funding Saves. MedBen Delivers.
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Benchmarking
MedBen Analytics' benchmarking capabilities enable you to compare your data against state and national norms and/or specific industries. You can narrow your benchmarks by plan type, number of lives and other metrics to get a true measure of how your plan stacks up.
Your benchmarking choice is immediately reflected on the dashboard content.
Straight RBP
Providers receive fair reimbursement by using Medicare pricing as the primary source of repricing. And because your plan no longer has a PPO, your plan members can go anywhere they choose for medical care.
Pharmacy Cost Plus Pricing
RBP for your prescription drugs.
Layered RBP
Target high-cost medical treatments, such as kidney dialysis.
An Extensive Reporting Library
Once you've chosen your population, reporting period and benchmark preferences, just sit back and watch MedBen Analytics go to work for you. Dozens of charts, graphs and tables, instantly generated. Our financial, clinical, risk and savings reports show you what is working with your plan while highlighting areas of potential improvement.
FSA Store is the largest online marketplace for guaranteed FSA-eligible products, helping flexible spending account holders manage and use their FSAs and save on more than 4,000 health items using tax-free money. You can pay for purchases using your MedBen FSA debit card so they are automatically noted on your account balance.
Use these convenient links for finding FSA-eligible products and calculating your FSA tax savings. FSA members can check their current account balances by visiting MedBen Access or downloading our mobile app from the Apple App Store or Google Play (search for "MedBen").
Use this secure 24/7 service portal to access claims and benefits information. MedBen Access enables you to:
- Check claims status
- Review benefit coverages
- Download explanations of benefits (EOBs)
- See deductibles, out-of-pocket costs and calendar maximums
- Look up drug information, compare local pharmacy prices and check availability of lower-cost equivalents
- Review FSA and HRA activity and balances
- Check wellness exam and screenings compliance (for WellLiving members)
If you need assistance logging in to MedBen Access or using its features, please contact MedBen Customer Service at 800-686-8425.
MedBen Access is also available as a mobile app with the same great features! Download it from the Apple App Store or Google Play (search for "MedBen").
Download the MedBen Client Report
Please register to download the Client Report. Thanks!
Frequently Asked Questions about using the debit card (PDF).
Download a list of participating pharmacies, discount stores and supermarkets that can identify FSA-eligible items at checkout using an Inventory Information Approval System (IIAS).
Download a list of participating pharmacies, discount stores and supermarkets that do not use IIAS, but 90% of whose sales come from medical care items (thus making them FSA-eligible).
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen Rx follows a simple philosophy: The client's money belongs to the client. Our pharmacy solutions are designed to get members the right drug at the lowest cost, with total transparency to the employer. These include:
- Pricing solutions that ensure clients pay just what the pharmacies pay.
- Appropriateness solutions to find the most effective drugs at the best cost.
- Access solutions that give members new ways to lower their drug cost.
Direct-to-Employer Contracting
Many MedBen clients blend their RBP plan with direct-to-employer (DTE) contracts, which promote the use of quality care through local providers. In exchange for encouraging members to visit contracted facilities, providers bill the plan at mutually agreed-upon rates.
MedBen has been facilitating DTE contracting for over a decade with doctors and hospitals across the Midwest, and we continue to gain access to more exclusive DTE contracting. This strategy ensures that when members utilize area providers, they receive the best pricing options available.
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