Today, employer-sponsored health plan administrators benefit from billing partnerships that offer software and data-driven solutions. Real-time price information regarding the true cost of care enables plan sponsors and members to make the most advantageous cost-benefit decisions regarding care options.
The right medical billing partner will be an agent of change, embracing innovation and advocating for “what is fair and just.” The right partner will also provide value-added services through turnkey solutions, innovative plan designs, administrative and compliance support, as well as legal representation of participants. The right partner will provide invaluable operations guidance, assistance in navigating the ever-changing federal and state healthcare regulations, identifying options to lower risk, containing and reducing costs and maximizing plan value.
As its name confirms, aequum, meaning “what is fair and just,” partners with its member clients to protect, support and advocate on behalf of plan members and dependents. To date, aequum LLC has defended more than 2,600 plan participants against more than 1,200 health systems and medical providers across the country saving plans and participants 97.2% of the disputed charges.
aequum is a first-of-its kind tech-driven company in the complex field of medical billing. We employ technical resources and a proprietary database that proactively protects plan members against excessive and reasonable charges. This includes out-of-network charges, known as balance billing, recovery of excessive provider payments, and protection from unfair debt collection practices. aequum’s tech-driven team of specialists partners with self-funded health plans, third-party administrators, insurers, medical cost management companies and stop-loss carriers throughout the country, providing administrative and technical support to these partners and legal support to their members.
aequum is also advancing the adoption of reference-based pricing and price transparency solutions to control costs, reduce spending and gain potential savings.
aequum’s relationship with Koehler Fitzgerald LLC, a respected group of highly rated trial and appellate lawyers, ensures that claims successfully navigate oft-changing federal and state healthcare regulations. Koehler Fitzgerald LLC attorneys litigate complex medical billing issues and favorably resolve medical bills on behalf of members.
Currently, there is a lack of medical billing price transparency throughout the healthcare industry. There is considerable room for improvement through claims analysis. Innovative medical billing services take on this challenge, utilizing powerful data-driven software and online data analytic tools that can provide a degree of price transparency. Real-time data leads to new insights by harnessing price data electronically – allowing fee comparisons that identity fair and reasonable prices.
Strategic actions that go far beyond simple compliance help ensure employer-sponsored, self-insured plans incorporate the most effective strategies for the “health and wealth” of their participants. These strategies include effectively designed acquisition cost-based pharmacy pricing, HSA-capable coverage, reference-based pricing, adequate participant protections against balance billing, and participant advocacy and litigation support.
Plan sponsors can significantly benefit from the value of a medical billing partner that is fully engaged in guiding plan administrators though today’s most effective and innovative strategies. As your partner, aequum health is here to address your concerns and help you and your plan participants succeed in 2022 and beyond.