Monthly Archive
for: ‘January, 2011’

Repricers and “Cost Containment” Solutions

In 2010, we saw an explosion in the number of benefit plans employing repricers and ―cost containment‖ companies. Typically, these companies offer to review charges submitted by providers and reduce the charge to a “reasonable’ amount under the auspices of “usual and customary” reimbursement. In exchange, the repricer is usually paid a percentage of the …

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Federal Health Insurance Reform

The Patient Protection and Affordable Care Act (PPACA) was enacted last year and created many reforms that have already taken effect: No pre-existing conditions for children Extension of dependent coverage for young adults Free preventative service benefits Abolishment of lifetime benefit caps Regulations on annual benefit caps Prohibition of coverage rescissions Expanded appeal procedures Additionally, …

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