No-Access-Fee and Heavily Discounted Diagnostic Imaging PPO Network

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Presentation transcript:

No-Access-Fee and Heavily Discounted Diagnostic Imaging PPO Network HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR  Innovation   Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: tference@hrmdco.com Website: www.hrmdco.com

No-Access-Fee and Heavily Discounted Diagnostic Imaging PPO Network -DI = 15% of national spend, 20% growth rate (twice that of Rx) 60% of all radiology costs and 80% of the total increase -National network w/ >1300 high quality/low cost locations -Provides MRI,CT & PET scans -Unique member/doctor concierge service to assure speed, accuracy and patient-conducive setting -Network bills the payor using a standard CMS-1500 billing form with the Network’s TAX ID # as the provider to be paid. -Carrier/TPA adjudicates the bill at 100% of billed charges, and full payment is made to Network. -All network facilities must meet NCQA standards

No-Access-Fee and Heavily Discounted Diagnostic Imaging PPO Network -All Radiologists -American College of Radiology accredited -0.186% error rate with 100% quality guarantee -Plan design must steer employees to network’s national Scheduling/Concierge department -Charges 20% to 30% less than employer’s current insurer/network discounts -Since 2000, US average DI cost trend = 17% but 0% for this network -There is no charge to the employer -Low cost/ no trend: ~primarily non-hospital facilities ~steerage guarantees Y-to-Y patient volume ~100% payment guarantee to facility -

State PPO Basic MRI Charge U&C Discount for MRI PPO Basic CT Scan Charge Discount For CT Scan CA $525 $3,084 83% $375 $1,742 77% GA 550 1,894 71 400 1,070 63 IL 500 1,885 74 375 1,065 55 AZ 525 1,585 67 956 53 MN 565 1,565 64 884 MO 675 1,846 450 1,043 52 NV 2,197 77 1,241 NJ 1,932 72 390 1,092 NY 2,165 350 1,223 OH 600 1,876 69 1,060 62 FL 1,959 78 1,107 68 TX 2,247 76 1,269 65

Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com Thank you for your potential interest in this fresh thinking