Healthcare's Final Frontier: Navigating the Wild West of RBP with Industry Renegades
Omar Arif of ClaimDOC & Scott Schnaidt of HST

Healthcare's Final Frontier: Navigating the Wild West of RBP with Industry Renegades Omar Arif of ClaimDOC & Scott Schnaidt of HST

Ever imagine healthcare could feel like the Wild West?? Welcome to the untamed lands of Reference-Based Pricing (RBP), the sizzling frontier where a select few employers unleash radical savings while giving the traditional PPO system a stiff arm.

Unveil a world where only 3-4% of employers dare to tread, but where jaw-dropping 30-40% savings rain like gold and concierge-level service is the sheriff in town.

Curious about RBP's magic? This isn't just healthcare. It's "Health-FAIR!" Here, employers "price-match" medical costs against benchmark prices, slicing their claims in half compared to big insurers.?

Projections say employer healthcare costs will shoot up another 7-9% in 2024. Yet Medicare Part D Premiums are projected to?decrease?by 1.8%. ?All major insurers participate in both markets.? The lesson? ?Employers with private insurance are subsidizing Medicare.? But hold your horses. With RBP, brace yourself for a 0-2% trend that turns the tables on traditional care.

Jump into this roller-coaster ride of a podcast with your guide through this maze, joined by two titans of the trade—Omar Arif of ClaimDOC & Scott Schnaidt of HST. ?They've both cracked the code, each in their unique ways, and the results? Nothing short of spellbinding.

?? What's on Tap:

  • The gears and levers behind RBP
  • Navigating the legal minefields
  • Secrets from Third-Party Administrators (TPAs)
  • RBP's performance across the geographical board
  • The art of handling balance bill claims
  • Litigation: When & How Often
  • Co-fiduciaries: The real deal or just smoke and mirrors?
  • Show Me the Money: Their pay structure dissected
  • Year-end Report Cards: The Good, the Bad, and the Profitable

And just when you think it couldn’t get any cooler—did one of these guys actually play pro baseball in a global tourney, while the other rocked the stage with NIRVANA? ???

Lock in your earbuds. Prepare for a mind-bending journey. You’re entering "The Repricers"—Healthcare’s Final Frontier! ????

Mary Lavigne

Project Assistant and Business Development at Superior BioDiagnostics

1 年

Has anyone here ever dealt with a company named Data iSight? They reprice out of network claims (Aetna is my insurance.). The reprice the claim to 40% LESS - and then stick the remainder on the provider to lower their fee's or for the patient to pay the balance. Absolutely criminal the way they claim to reprice a providers fee's and they try strong arm them into lowering. The patient is ultimately left with a the 40% saved for Aetna as their bill.

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Sarah J. Erickson

Driving Revenue Growth. Experience working directly with high level decision makers including CEOs, C-Suite Executives, VPs, VC/PE Investors.

1 年

This is great, Scott Schnaidt ! ????

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Omar Arif

SVP of Growth @ ClaimDOC

1 年

Thanks for having me on Craig Gottwals. Sorry I could only bring my B- game since you chose to record on a Sunday right before the Cowboys game. Thanks for being a good sport Scott Schnaidt. Nothing wrong with some friendly competition. Keeps us all honest!

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Melissa Messer, LUTCF

I do the shopping for you to find the best programs for your auto, home and life insurance needs! I am licensed in CA, HI, OR, TX, TN, ID, NV, AZ and PA

1 年

Well written and eye opening on the current market conditions!

Mike Sigal

Employee Benefit Sales Specialist in Small Group, Mid-Market, National Accounts — Team Leadership - Market Trends & Competitive Analysis in the insurance industry — C-Suite Engagement — Relationship & Channel Management

1 年

Wow!

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