by Al Lewis
The short version of the story: you can actually save money by covering 100% all bills for all corona treatments up to 2x Medicare. But only if you give employees Quizzify’s surprise bill Prevent Consent and teach them how to use it to cap their/your total financial consent for emergency treatment at 2x Medicare. Otherwise 100% coverage could cost a lot of money.
For employees who use this surprise bill “Prevent Consent,” 100% coverage will then cost you less than standard coverage without the Prevent Consent.
And now, for the rest of the story
Seems like ancient history, but before coronavirus, the big healthcare news was surprise billing. The statistics were quite compelling. 57% of commercially insured Americans report having received one, for example.
While we are now best known for our coronaquizzes, played probably 100,000 times to date, it was our solution to surprise billing for emergencies that, to use the cliché-du-jour, went viral, being featured in the New York Times last month.
How did we make the New York Times? Simple: we solved the problem of surprise bills for emergencies. Don’t believe us? Read the article and our links.
In most states, if you don’t think your employees are getting surprise bills, that’s not because the bills aren’t high. It’s because employee share is low, either due to a low deductible and co-pay, or due to having already reached their deductible and paying low co-insurance. Hence you don’t hear complaints.
Absent complaints, these bills are being quietly auto-adjudicated and paid. Like the dirt from the tunnel in The Great Escape being sprinkled around the Stalag, these surprise bill expenses are sprinkled throughout your total spend. You wonder why you spend so much money in total, so you sort your spending every which way -- except this one: the multiple of Medicare for out-of-network providers in in-network facilities. That’s where these surprises are lurking.
Further, because elective care utilization (where our solution does not apply) has trended way down, your total spend may be artificially depressed this year. That makes you even less likely to notice these surprise bills for emergencies.
Surprise bills and coronavirus
Many insurers are waiving out-of-pocket fees for coronavirus treatment. Who do you think ends up paying for that waiver? Hint: it rhymes with “you.” Have you tracked health insurance stock performance lately? Far outperforming the market, kind of the opposite of what you would expect, right?
As an ERISA plan, you don’t have to go along with your carrier’s policy for corona coverage, but most of you are or will be.
This sets you up for the worst kind of surprise bill: one where the employee doesn’t complain. (See the previous section.) Therefore, you have no idea the bill even happened.
Surprise bills: now more than ever
Our solution works. It has been reported publicly twice, and privately to us several more times. It is right here. And it has never been more relevant than now, as this BenefitsPro article describes.
The reason for the increased relevance is that while our solution applies only to emergency admissions, visits, deliveries and transfers (and not to elective care), most medical care today fits those categories.
Since the majority of surprise bills involve those categories, surprise medical billing is now front-and-center. And as that BenefitsPro article described, employees are almost as fearful of the financial consequences of coronavirus as they are of the disease itself.
Whether or not you or your insurer have arranged special coverage for treatment, someone is paying for it. Therefore, your only option to avoid being hosed is to teach employees to use the Quizzify Prevent Consent. The optimal solution: offer full coverage to employees, and only to employees, who use it.