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Reference based PPO

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Reference based PPO

Reference-based PPO: Take control of your healthcare costs with a plan that utilizes reference-based pricing. Say goodbye to unexpected out-of-network bills and hello to cost-effective, quality care.

What is Reference based PPO?

A Reference-Based Pricing (RBP) is a type of health insurance plan that sets a maximum reimbursement rate for medical procedures based on a benchmark, such as the Medicare fee schedule or a regional average. It is also commonly referred to as "Reference-Based Pricing PPO" which is a type of Preferred Provider Organization (PPO) plan.

What are the benefits of Reference based PPO?

  1. Cost Savings: Reference-Based Pricing PPO plans are designed to help keep healthcare costs down by setting a maximum reimbursement rate for medical procedures based on a benchmark such as the Medicare fee schedule or a regional average.
  2. Control over costs: It gives employers and individuals more control over their healthcare costs by ensuring that they are only paying a fair price for medical procedures.
  3. Transparency: It provides clarity on the cost of medical procedures and helps the patient to make more informed decisions about their healthcare.
  4. Flexibility: It allows patients to choose from a network of providers, similar to a PPO plan, giving them flexibility and choice in their healthcare.

Why do you need to hire a professional for Reference based PPO?

There are several reasons why you might need a professional for Reference-Based Pricing PPO:

  1. Understanding the plan: A professional can help you understand the details of the Reference-Based Pricing PPO plan, including how it works, what it covers, and what your responsibilities are as a policyholder.
  2. Navigating the healthcare system: A professional can help you navigate the healthcare system and find providers who accept the reference rate, so you can get the care you need at a fair price.
  3. Handling claims: A professional can help you navigate the claims process, ensuring that your claims are handled correctly and promptly.
  4. Keeping up with updates: Health insurance policies are constantly changing. A professional can help keep you informed about updates and changes to the plan and ensure you get the best deal possible.

Overall, a professional can ensure that you are getting the most out of your Reference-Based Pricing PPO plan and that you have the support and guidance you need to make informed decisions about your healthcare.

We would like to learn more about your Reference based PPO? Schedule a call today

It might be time to switch insurers whenever the service that your existing insurer provides doesn’t meet your needs. For example, if you have a poor claims experience or an unexplained rate increase, it might be time to consider other options

If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.

Contact us today to help you with multiple options to choose from.
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We extend coverage to individuals and businesses in Melville, NY and surrounding areas.
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