Discount Cards

[Guest]

Not on a discount plan.

There are no insured benefits.

Now if you are selling AIG Value Plan . . . .

Ha, ha, ha, ha . . ..

Maybe we're talking about two different things, if we are my apologies.

 

[HomeService]

robliano: do you actually call this stuff, "insured benefits" in the company of clients??? this discount program stuff?

 

[Guest]

robliano: do you actually call this stuff, "insured benefits" in the company of clients??? this discount program stuff?

While it's obvious your question is rhetorical, I call them "limited benefits" as this is what they are.

You see, people who are declined, can't get medicaid, can't afford high risk or GI plans etc, etc, etc, actually realize that they aren't getting major medical, it's quite simple.

 

[J.R.]

Each of us can agree to disagree about the efficacy of limited benefit plans, discounts, etc., but the truth is this.........we need to open up health care to the market and let the market determine what prices are. The problem, if one were to call it that, which I don't, is that most of the prices are secret amongst the insurance carriers and providers. Some hospitals, outpatient clinics, etc. are beginning to list their prices in an effort to drum up more business. I hope more facilities come on board.

I really don't see the problem in offering any type of discount plan, limited benefit plan, etc. as long as the benefits are valid and the doctors accepts the plan.

Maryland has dumb ass rule about not accepting discount cards at hospitals, as well as a few other states. For whatever reason, some states think that competition is a bad thing.

Can anybody on this forum provide a copy of the EOB equivalent for one of these plans???

This must assuage some of the various viewpoints about these plans.

 

[myinsurebiz]

I would not waste my time selling these type of products.

#1 - From what I have seen they are using weak networks.

#2 - I also heard that the doctors are making these card holder pay the claim up front and then wait for reimbursement.

Anyone else hearing that?

1) What? PHCS, BeechStreet, 3Rivers - weak? Too Funny!

2) Reimbursement? With a Medical Savings Card (sometimes called a discount card) - there is no reimbursement. It's all paid at POS at a repriced figure. You must be confused?

While it's obvious your question is rhetorical, I call them "limited benefits" as this is what they are. You see, people who are declined, can't get medicaid, can't afford high risk or GI plans etc, etc, etc, actually realize that they aren't getting major medical, it's quite simple.

Rob,

I believe you are thinking about a limited benefit or mini med type plan. A discount card or medical savings card as no indeminity, insured benefits, etc - just repriced discounts.

#1 - I really don't see the problem in offering any type of discount plan, limited benefit plan, etc. as long as the benefits are valid and the doctors accepts the plan.

#2 - Can anybody on this forum provide a copy of the EOB equivalent for one of these plans???

1) True That!

2) There are no benefits other than the vendor repricing their fees based on their contract with the PPO network to members of the PPO - which the buyers of the discount cards become - PPO members - basically.

Tom

 

[J.R.]

2) There are no benefits other than the vendor repricing their fees based on their contract with the PPO network to members of the PPO - which the buyers of the discount cards become - PPO members - basically.

Exactly my point. Show me the bill with the original amount and then the final amount with the discount. The benefit I was referring to is the repricing since that is what mostly all the discount plans tout.....but they are leaving things on the table.

 

[myinsurebiz]

Exactly my point. Show me the bill with the original amount and then the final amount with the discount. The benefit I was referring to is the repricing since that is what mostly all the discount plans tout.....but they are leaving things on the table.

Actually most State's DOI discourage this practice. You may call the billing office or office manager at your vendor / facility and give them the procedure codes and ask for a pre-visit repriced quote.

Or - if you wish you may always forward an email to the TPA requesting this information before visiting a vendor and seeking services.

Back in the day we could use a redacted invoice display - but were chastised by several DOI's and the Networks disallowed this practice.

Tom

 

[DarrylVK]

I would not waste my time selling these type of products.
From what I have seen they are using weak networks.
I also heard that the doctors are making these card holder pay the claim up front and then wait for reimbursement.


Anyone else hearing that?

Nope,

Remember these plans are usually NOT Insurance.

The customer presents card to dentist at time of service & gets the discount taken right off the bill as he pays it.

That's why they are called Discount Cards.

AmeriPlan

 

[somarco]

Maryland has dumb ass rule about not accepting discount cards at hospitals, as well as a few other states.

I fail to see what is dumb about this.

The discount is only good if you have the cash to pay on a timely basis.

Your HEALTH INSURANCE card is like a credit card with a $3M+ line of credit. Not so with a discount card.

The discount companies don't have any skin in the game. They piggy back on rented PPO networks, mark their entry fee up by 300% or more to support the commission structure.

There is no guarantee the hospital or any other provider will ever see their money. Uninsured patients, with or without a discount card, stiff the providers on 90% of the bills.

Try walking into a 5 star restaurant with a discount card in your hand, no cash and no credit and see how far you get.

The discounts are not instant except some primary care services. Most of the discounts, with any plan, come after the claim has been filed and adjudicated.

If you are selling a discount plan on the promise of cash back you are in trouble.

If you are selling a limited benefit plan, there are some cash benefits. However, I do hear stories about claims being denied by these plans. Talked to a guy a few weeks ago with a limited benefit plan. His wife broke her leg and required surgery. The claim exceeds $24k. The carrier denied the claim as pre-existing . . .

That was 5 months ago.

Yeah, these plans are great.

 

[ABC]

What discount plans have contracted with PHCS?
I guess its possible.

If you walk into a Doc office with a discount card they realize there is no insurance to pay any part of the claim. So they are charging up front and then filling the claim. At that point the discount holder might be eligible for reimbursement from the Doc. I am even hearing that some of the Doc make the card holder file the claims with the ppo for discount.

I am hearing this from physicians working in private practice.

Any of you selling these plans ever follow a claim?