Reference Based Pricing

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Reference Based Pricing recognizes medical provider's actual cost to deliver the service and ensures a fair margin above provider's published cost. Consultants and Brokers are limited in their ability to deliver true health care cost reduction services. The biggest bang for the buck is derived from cost shifting to the employer. This can only be taken so far and the ACA limits the financial impact to the employee.

The logic of a wellness plan cannot be argued; however, the cost reductions will not be realized for several years.

There are several other important cost reduction tactics, however, nothing possesses more cost reduction than reference-based pricing.

Typical first-year savings for most self-funded plans is over 30%

Very few Reference Based Pricing vendors are "trouble free." An employer can have serious benefit plan payment problems (including Liability) if this process is not delivered with "all bases covered." All of our vendor's recommendations are fully vetted. We are your number 1 choice in Healthcare Consulting - Outsourced HR Solutions vendor!

Reference Based Pricing is a No-Network, all providers and facilities are available nationwide, solution. Provider pricing (established by Medicare) creates a base price representing true cost = 100%. Out of network cost is as high as 16,000% of Medicare. PPO's are typically set at 225%.

When your network provider or insurance company negotiates a lower settlement, something below 225%, who gets the difference? Not You!

Do you need a PPO Network? Not necessarily. Look at all the new plans entering the market today, narrow network designs combined with a reference based solution. Do you need claim auditing? Absolutely! Included in our solution.

There are significant shortcomings with most reference-based vendors. Only a handful "Do it Right." Veridence 365 has a fully vetted, best solution vendor in the country, delivering a working fair pricing healthcare payment model. Veridence 365 deliverable is a comprehensive A to Z solution for Self-Insured Employers and Third Party Administrators - getting it right the first time & saving you up to 35%!

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We Excel at Risk Management; Administrative Technology; Benefit Management; Cost Containment

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We search out and vet the newest, most innovative technology, products, and administrative resources that deliver a comprehensive benefits management solution, managing your entire healthcare supply chain. We provide benefit administrators and Human Resource managers a total outsourced benefit management solution built around evolutionary "Next Generation" technology and services. Dynamic Group Presentations delivers improved evidence-based, measured financial and clinical outcomes. None of our competitors match our brilliantly conceived, high-performance employee benefits management solution. Culture change begins and members are financially incentivized to choose healthier lifestyles.

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