Where we’re going

A growing number of plan sponsors are starting to feel a new type of pressure  – and it’s not just from rising health care costs. There is a realization that others may be gaining a competitive advantage they don’t yet have, introducing a sense of FOMO (Fear Of Missing Out) that is starting to influence … Continued

The relationship between health plans and providers is one of the most important and most complex dynamics in healthcare. It directly shapes cost, experience and long-term plan performance. Yet for many self-insured plans, that relationship is not actively managed. It is experienced after the fact, through claims, billing disputes and unexpected costs. aequum approaches provider … Continued

When the No Surprises Act (NSA) took effect, it was widely viewed as a major step forward in protecting patients from unexpected medical bills and curbing excessive out-of-network pricing. It created clear standards around balance billing, established payment frameworks and introduced the federal Independent Dispute Resolution (IDR) process to help resolve payment disagreements between plans … Continued

The No Surprises Act (NSA) was designed to reduce unexpected medical bills and create a fair process for resolving out-of-network payment disputes. Central to that framework is the Independent Dispute Resolution (IDR) process, intended to bring balance between providers and payers. What it did not anticipate was how that process could be used at scale … Continued