Balance billing has long been a contentious issue, leaving patients vulnerable to unexpected medical bills, harassment from collection agencies, and financial distress.
Despite efforts to address this problem, traditional solutions have fallen short. Now, there’s finally a breakthrough: WellRithms’ Shield Indemnification™, a unique captive insurance solution that protects patients from excessive billing.
Read our newest white paper, “The Wait is Over: Guaranteed Protection from Balance Billing” to learn about this captive insurance program that transfers the risk exposure for excessive claims away from payors and members. Providing guaranteed protection from balance billing, Shield Indemnification™ assumes the risk of individual medical bills to ensure that providers are paid appropriately, and patients are shielded from financial liability.
The Challenge of Balance Billing
With balance billing, healthcare providers bill patients for the difference between the provider’s charge and the allowed amount under the patient’s insurance plan. It’s most problematic when patients see providers and use hospitals outside of their health plan’s preferred provider network. Balance billing has gone on for decades, forcing patients to deal with collection threats and suffering financial consequences including damage to their credit ratings and even personal bankruptcy.
How Shield Indemnification™ Works
Unlike traditional captives, which manage risk across groups of covered lives, Shield Indemnification™ focuses on indemnifying health plans and members from individual medical bills. This unique approach sets in place a legally defensible strategy to reprice medical bills and fully absorb the associated risk. With Shield Indemnification™, patients can rest assured that they will never be at risk financially for a balance bill.
The Precision of Sustainable Claims Pricing™
To further enhance payment integrity, WellRithms combines Shield Indemnification™ with its proprietary repricing system, Sustainable Claims Pricing™. This methodology ensures accuracy in claims payment by repricing medical bills based upon various factors, including hospital cost-to-charge ratios, geographical cost variations, and inflationary adjustments.
Going Beyond Indemnification
While Shield Indemnification™ provides essential protection against balance billing, its impact goes beyond indemnification alone. By shielding patients from financial liability, it removes the stress and uncertainty associated with unexpected medical bills. Patients can focus on their health and well-being without worrying about exorbitant healthcare costs.
Learn More
To learn more about how Shield Indemnification™ is putting an end to balance billing, download our white paper here. You can also read more in our latest press release here.
For more information visit https://www.wellrithms.com.
