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True Freedom of Choice No Networks – No Penalties Provider Freedom.

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Presentation on theme: "True Freedom of Choice No Networks – No Penalties Provider Freedom."— Presentation transcript:

1 True Freedom of Choice No Networks – No Penalties Provider Freedom

2  Who is Allied * Home Office - Overland Park, Ks. * 2 nd generation business * Founded 1970 * Proprietary systems * Company culture Innovation Stability Service 2

3 Overview Problems with PPOs Provider Freedom is the solution How Provider Freedom benefits you How Provider Freedom works 3

4 What is a PPO Plan? Managed Care First PPO network in mid 1980s - Early networks small local and regional health plans Grew to national networks as health plans grew and merged Provides discounts to retail health care costs Percent discounts off retail Per diem schedules Fixed rate for service 4

5 Problems With PPO Plans Poor DiscountsLimited provider choices Which hospital ? Which doctor ? Penalties, Penalties, Penalties Out-of-network Non-network providers within in-network hospitals Out of area Tough to switch health plansMulti-State Employers 5

6 Provider Freedom is the Solution! True freedom of provider choice No networks No penalties Better than PPO discounts 6

7 A Proven Model Tested NationwideProven DiscountsHigh Consumer Satisfaction 7

8 How Provider Freedom Benefits You Easier to change health plans Eliminates network penalties Reduces employer’s costs Very popular with employers/ employees 8

9 How Does Provider Freedom Work? Data ISight Payment Model Cost plus “fair and reasonable” discounts 9

10 Learning to use Provider Freedom Members pay only normal copays, deductible and coinsurance No balance bill guaranty We educate members when they get ID card We educate providers 10

11 “…covered person not responsible for any attempt by the medical provider to collect unpaid medical charges…” Excludes  Deductibles, copays, coinsurance  Medical care not covered by plan  Improperly filed claim  Late claim filing Call Allied National Customer Service for balance bill issues: 800-825-7531 No Balance Bill Guaranty 11

12 Provider Claim Payment Acceptance 92.0% - Accepted as paid 4.0% - Call and accept 3.5% - Adjust and accept 0.4% - Adjust to retail 0.1% - Balance bill Provider Freedom 12

13 Your initial provider appointment using Provider Freedom:  Present your ID card  Majority of providers currently accept the card  Allied pays claims to over 250,000 providers  If your provider is uncertain about the Provider Freedom plan, call Allied Customer Service: 800-825-7531 Provider Freedom 13

14 Available with Funding Advantage in these states: California, Georgia, Iowa, Illinois, Indiana, Kansas, Missouri, Nebraska, Nevada, Ohio, Oklahoma, South Carolina, Tennessee, Texas Provider Freedom 14

15 Allied™ Provider Freedom Choose any provider Lower premium and out-of-pocket costs Eliminates out- of-network penalties How Provider Freedom benefits you Easy to change providers 20

16 Allied National www.alliednational.com 4551 W. 107 th St., Suite 100 Overland Park, KS 66207-4037 Questions? Need More Information? Allied Customer Service: 800-825-7531 We’ll be happy to answer your questions now. 11221s1213


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