Hospital - Insurance Carrier Price Negotiations Explained

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AHealthcareZ - Healthcare Finance Explained

Күн бұрын

Hospital - Health Insurance Carrier Price Negotiations Explained.
In this Training Session You Will Learn the Contracting Methodologies Used to Determine Health Insurance Carrier Discounts with Hospitals.
1) Case Rate
2) Percent of Charge
3) Carve-out
4) Provider Stop-Loss + More
You will then understand their implications on healthcare costs for employer-sponsored plans.

Пікірлер: 22

@garyschreiber695 10 ай бұрын

An excellent series. Ive been practicing medicine for over 30 years. I knew that billed charges had no connection to reality but never knew how price negotiations worked.

@ahealthcarez 10 ай бұрын

Super! Thank you for your feedback.

@tuvale Жыл бұрын

This was amazing. I just came out of an admission for pneumonia and also, my insurance is in negotiations with the facility I normally go to. Full circle! Very relevant info and opened my eyes.

@ahealthcarez Жыл бұрын

Thank you for watching. Hope you are doing better.

@petergrimes9252 Жыл бұрын

Eric, thank you for the trip down memory lane. DRGs, per diems etc r terms from the 90s. Love the "landmine" references

@ahealthcarez Жыл бұрын

Thank you for watching and for your comment.

@eliortega6533 Жыл бұрын

i like the slide show presentations. i’m a healthcare management student and this channel has sparked my interest 10 fold, keep it up

@ahealthcarez Жыл бұрын

Thank you for watching!!

@petergrimes9252 Жыл бұрын

Eli, we need you as the next generstion of health care leadership ! 🍎

@Iwonder2 Жыл бұрын

please discuss the marketplace plans that either through premiums or deductibles or a combo of both you pay at least 10,000.00 out of pocket if you need any care beyond preventative care?So basically we pay to have insurance but are paying for things like kidney stones out of pocket.Then the year is over and you start over with anew deductible. Folks then can't afford any more care cuz they are broke after paying the 10,000.00 dollars the previous year.

@ahealthcarez Жыл бұрын

You are correct. Thank you for your comment.

@sourcebest Жыл бұрын

Dr.Bricker, great work! Can you make a video talking about insurance reimbursement on outpatient freestanding imaging? They might not charge $2000 for an MRI exam? What's the future for those walk-in clinics and op imaging center? Thank you!

@ahealthcarez Жыл бұрын

Thank you for watching and for your suggestion.

@LawOfAttraction536 Жыл бұрын

Does the allowed amount equal to all insurance coverage and patient payment(deductibles, copay, out of pocket). So when we talked about savings? What are we talking about savings for whom?

@ahealthcarez Жыл бұрын

Great question. You are correct. Therefore, may be totally patient responsibility if part of the deductible or totally plan responsibility if after out-of-pocket max or some combination of patient and plan if in between deductible and out-of-pocket max. Clear as mud. 😉🤦‍♂️

@gardnmi Жыл бұрын

Now that all the plans are publicly available for every provider, procedure, and payer due to that Transparency in Coverage mandate, do you see any major changes that will occur on how these plans will be negotiated?

@ahealthcarez Жыл бұрын

Likely will continue to be hidden, IMO. Thank you for watching and for your question.