You Can't Fix Healthcare Without Fixing Healthcare … · Personalized Concierge Service ......

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801.783.3391 www.assertahealth.com Simple, One-Time Set Up x medEcash stages funds from the consumer and payer in advance, then administers immediate cash payment when the consumer hits the “pay” button on our mobile app. We can also administer a single bundled payment and automatically distribute funds to individual providers on the back end. No Provider Claims or Billing x medEcash creates an administrative record of care and feeds it through the payer’s usual administrative process, so that no important data or information is lost. Personalized Concierge Service x We guide consumers step by step through the entire processfrom understanding their options to appointment scheduling, pre-certification, pre-funding the procedure, and preparing to execute payment at or before the time of service. You Can't Fix Healthcare Without Fixing Healthcare Payment Third party payment is a barrier to consumer engagement. It adds unnecessary cost, confusion and complexity, and it’s a major barrier to innovations, like price transparency, direct primary care and new models of care management and coordination. Our mission is to lower health care costs by improving the consumer experience and removing unnecessary administrative costs no one will miss. Our medEcash payment platform enables consumers to pay the full, transparent cash price for healthcare services at or before the time of service, even when all or a portion of the funds come from their employer or health plan. medEcash makes consumer engagement work it’s a better way to pay for health care, and a better experience for all parties - consumer, provider, and payer. Safe, secure ACH transactions + high touch consumer support = a better experience for all parties to the transaction.

Transcript of You Can't Fix Healthcare Without Fixing Healthcare … · Personalized Concierge Service ......

801.783.3391 www.assertahealth.com

Simple, One-Time Set Up x medEcash stages funds from the consumer and payer in

advance, then administers immediate cash payment when the consumer hits the “pay” button on our mobile app. We can also administer a single bundled payment and automatically distribute funds to individual providers on the back end.

No Provider Claims or Billing x medEcash creates an administrative record of care and feeds it

through the payer’s usual administrative process, so that no important data or information is lost.

Personalized Concierge Service x We guide consumers step by step through the entire process—

from understanding their options to appointment scheduling, pre-certification, pre-funding the procedure, and preparing to execute payment at or before the time of service.

You Can't Fix Healthcare Without Fixing Healthcare Payment Third party payment is a barrier to consumer engagement. It adds unnecessary cost, confusion and complexity, and it’s a major barrier to innovations, like price transparency, direct primary care and new models of care management and coordination. Our mission is to lower health care costs by improving the consumer experience and removing unnecessary administrative costs no one will miss.

Our medEcash payment platform enables consumers to pay the full, transparent cash price for healthcare services at or before the time of service, even when all or a portion of the funds come from their employer or health plan. medEcash makes consumer engagement work – it’s a better way to pay for health care, and a better experience for all parties - consumer, provider, and payer.

Safe, secure ACH transactions + high touch consumer support = a better experience for all parties to the transaction.

Cash prices save money for self-pay consumers, but what about consumers with insurance?

With medEcashSM, consumers pay the full cash price at the time they receive services—even when all or part of the funds come from their health plan.

Here is how it works:

Consumers work with our concierge service to guide them through an entire episode of care. Consumers benefit from shared savings incentives when we steer them to high-value providers.

1) medEcashSM providers agree toaccept a “cash pay” rate inexchange for payment at orbefore the time of service.

2) Providers complete a simple,secure one-time set up process tocreate a medEcashSM account andestablish a secure link to the bankaccount where they want toreceive payment.

3) We work with the consumer and their employer or health plan to pre-fund the full cash price of the procedure.

4) We coordinate appointment scheduling and assist consumers with any required pre-authorization.

5) Our medEcash℠ platform enables the consumer to pay providers directly using our mobile app on the day of service.

When the consumer hits the “Pay” button, the funds are immediately transferred to the provider's medEcashSM account without transaction fees. Funds are then transferred directly to the bank account linked to the provider's medEcashSM account.

6) We generate all of the documentation required by the employer or health plan and submit it through the plan administrator's preferred process. The consumer receives no bills and the provider is not required to submit a claim.

Our medEcashSM payment platform dramatically simplifies billing and eliminates bad debt risk for providers.

Consumers who use medEcashSM get step by step guidance, cost saving incentives and no billing or payment hassles – all of which help to ensure they have a positive experience—one they will share with their co-workers.

We can also help self-funded employers get more value from innovations like work site clinics, direct primary care and medical tourism by steering consumers to a pre-selected list of medEcashSM providers.

medEcashSM makes it possible for consumers to pay the full cash price at the time of service, even when all or part of the funds come from their employer or health plan.

B e n e f i t s of Direct "Cash" Payment

Ø Eliminates claims and billing, which add novalue and create complexity and confusion

Ø Creates improved transparency throughknown prices before service delivery

Ø Empowers consumers, who complete thetransaction at the time of service

Ø Enables employers and health plans to takeadvantage of “cash” prices without losing “claims-based” administrative data

Ø Enables employers and health plans to offer“Shared Savings” when engaged consumers make good decisions that benefit them AND their plan

Recent Direct Payment Results

Asserta Health’s Concierge Service

Third-party payment adds cost, confusion, and complexity because it removes the consumer

from the transaction.

Our unique consumer support model delivers a superior consumer experience as we work to

enhance the total value of the health plan’s Direct "Cash" Payment program.

We have the flexibility to fit into the health plan’s existing workflow. We completely customize our approach for each client to minimize disruption and maximize value, from the

way we receive referrals and inbound calls to the method we use to transmit claim

information for adjudication and reporting purposes to the language we use to answer the phone and steer consumers to the best option.

Focus on Consumer

We focus on the unique needs of each consumer and do everything we can to eliminate cost, confusion, and complexity as we educate and guide consumers to the highest value option available. Ø During our first call with a consumer, we ask and

answer questions, determine what service is needed,and help the consumer understand how their planworks.

Ø We gather any additional information required tohelp the consumer explore options and make good,high value decisions.

Ø We walk through each option and help themunderstand trade offs.

And we don’t stop once the decision is reached. We are there to make sure the consumer knows what to expect, every step of the way. Ø We assist with high value provider selection and

appointment scheduling.Ø We support the provider’s preferred workflow and

care plan, simplifying administration by assisting withpre-certification and registration.

Ø We confirm cash prices and negotiate in advancewhen necessary, then prepare the consumer toexecute direct “cash” payment at the time of serviceeven when all or a portion of the funds comes fromtheir employer or health plan.

After the procedure, we continue to provide consumer support and reassurance.

Ø We want consumers to focus on recovery instead ofworrying about a pile of unintelligible bills.

We are there to explain

the expected… and

handle the unexpected.

Claims and Billing add ZERO value to health care outcomes.

801.783.3391 [email protected]