Do You Understand Fair Market Claims Repricing?

Posted on July 10, 2013

I was asked an interesting question the other day.

“How does Fair Market Claims Repricing compare to Medicare based claims repricing?  We are moving all non network claims to Medicare based pricing and wonder if your Fair Market Pricing should be an option we should be considering?”

It’s a good question for all of us.  I thought you’d be interested so the answer is in today’s blog.

Here’s the deal. Moving to Medicare might save money for the Plan/Employer but not the Employees.

Providers will balance bill the Employees on just about every claim.  They will not accept Medicare pricing as payment in full, because it is not Medicare.  The patients will be stuck paying the balance on every claim that is out of network.  Also Medicare pricing could lead to a high percentage of appeals and/or potential legal actions by providers if they feel paying at Medicare is not justified.

Since our Fair Market Pricing is based on benchmarks of data, the providers accept our payment and if balance billing does occur we get involved on behalf of the patient to defend and settle the claim.

If you are looking to develop new income streams while providing an exclusive and valuable service saving your clients substantial money on health care costs, Fair Market Claims Pricing™ is worth taking a serious look at.

Please don’t hesitate to get in touch with me if you have questions. You can go to to request complete information.

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