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Patient Advocacy Services
for the Self-Funded

Helping the self-funded community find RBP-friendly providers so that they can be better healthcare consumers.

Patient Advocacy Services Patient Advocacy Service Tools

The Innovate360 cost-containment solution gives you the freedom of choice and price transparency you need to lower employee out-of-pocket expenses and reduce the potential for balance bills. Payer Compass goes the extra mile for your employees with exclusive Safe Harbor provider lists and robust patient advocacy services that help them optimize care and get the most out of their plan.

Our member education and provider education programs are designed to inform all stakeholders about the rationale for moving to a Medicare reference-based pricing plan. We are here to answer any questions that employees, board members, or providers might have during or after the transition, and in the rare event that a balance bill does pop up, you can count on our dependable team to resolve the issue swiftly and efficiently.

 

Member Education

Our member liaison program:

  • Educates members on the advantages of switching to reference-based pricing
  • Does outreach to bring members’ providers on board and refers members to accepting providers
  • Ensures a seamless transition with comprehensive member support

Increased interest in Medicare reference-based pricing plans from the self-funded market has led to the need to support these plan members with a rigorous patient advocacy program. While Innovate 360 is a turnkey program offering an easy-to-understand methodology, we have developed additional educational and outreach services to cover all of the potential challenges that could arise and help you implement your plan to the greatest benefit.

Provider Education

Our provider liaison program:

  • Encourages provider acceptance of reference-based pricing
  • Communicates group plan information to providers
  • Transparently shows how our price estimates are reached

Providers sometimes need a little handholding to bring them on board with Medicare reference-based pricing plans, which is why we have developed an extensive program of provider education, guidance, and support, both during the transition and beyond. Less than 2% of healthcare claims processed by Payer Compass are billed beyond the plan amount. On the off chance this occurs, we engage providers with the highest degree of professionalism and a non-adversarial approach to arrive at a negotiated amount that satisfies both sides and motivates providers to accept reference-based pricing long-term.​

Client Liaison

Our client liaison program:

  • Gives clients access to the patient advocacy portal 24/7
  • Provides answers to your questions
  • Maintains an updated Safe Harbor list of accepting providers
  • Provides detailed, ongoing reporting

Innovate360 comes with a fully integrated Patient Advocacy system. The client portal is easy to access when you have questions about where to find quality care. Our clients receive access to a safe-harbor list of accepting providers, along with detailed reporting, educational materials, and expert guidance. We have an extensive track record of successfully managing reference-based pricing programs, providing prompt and clear answers to client questions, and negotiating win-win solutions with providers.

Balance Billing Support

Our dedicated balance bill support team:

  • Coordinates with TPAs.
  • Reaches out to providers to resolve balance bills up to the plan limit.
  • Keeps members continually updated on the status of the response process.

With reference-based pricing, balance bills account for less than 2% of all bills. Payer Compass works as a liaison with the provider to encourage acceptance, negotiate with the provider at the client’s request, and keep members up-to-date on the entire process.

Full-Service Patient Advocacy Program

Contact Payer Compass to learn more about our proactive approach to patient advocacy services, which offers comprehensive support for employers, patients, third-party administrators, brokers, and providers alike.