| Q: | | "How does participation
in the ValuePoint by MultiPlan program benefit me?" |
| A: | | By
extending access to your MultiPlan contracted rates to consumers paying for their own healthcare,
you gain access to a new and growing patient population with no direct marketing costs and no
increase in your accounts receivable. You benefit from patient steerage, administrative ease,
and low collection risk. Your participation also gives you the opportunity to promote services
you may offer that aren't typically covered by a member's insurance plan. |
| Q: | | "How does ValuePoint by
MultiPlan benefit my patients?" |
| A: | | As more
and more consumers face high insurance deductibles, reduced or even discontinued group insurance
benefits, they will be forced to shop for cost-effective healthcare services. ValuePoint by
MultiPlan gives consumers access to medical providers that offer discounts to reduce the balance
they owe the provider directly. |
| Q: | | "How are ValuePoint by
MultiPlan members directed to me?" |
| A: | | You are
listed on our clients' websites and also referral is made available through a call center that
members can contact to find a provider. |
| Q: | | "How do ValuePoint by MultiPlan
members make an appointment with my practice?" |
| A: | | The member
visits a website or calls a toll-free service to identify participating providers based on their
location and desired healthcare services. Once you are selected, the member is instructed to call
you directly to make an appointment, and is also given a confirmation letter to present to you at
the time of service. Our client will also call you within 24 hours of the selection to alert you
to the member's interest and answer any questions you may have about the program. |
| Q: | | "How do ValuePoint by MultiPlan
members make arrangements for admission to my facility?" |
| A: | | For
non-emergent services, the member and/or his physician selects your facility from the website or
telephone service, and then is instructed to call your admissions office directly to make an
appointment. Upon selection, the member is also given a confirmation letter to present to the
registration clerk at the time of service. This confirmation letter reinforces the member's
obligations, and includes an expiration date that proves the member's eligibility for the program.
Selection of your facility also results in a call from our client within 24 hours to alert your
admissions office to the member's interest and answer any questions they may have about the program.
This gives your organization additional time to establish financial arrangements with the member
prior to admission. For emergency care when there is not time to search for a participating hospital,
the member presents his/her ValuePoint ID card when contacted by the billing office. |
| Q: | | "How do ValuePoint by MultiPlan
members know what their payment obligation is?" |
| A: | | Our clients
make it very clear to members during promotion, enrollment, on the member ID card, and during the
provider selection process that the program is not an insurance plan. Members are provided with
information including ranges of discounts that are based on the providers' MultiPlan contracted
rates, and are clearly informed that the discount is offered only in exchange for payment in full
at the time of service (or according to a payment timeframe you may elect to establish). Members
searching for facilities are also informed that admission to a facility may require proof of their
ability to pay. |
| Q: | | "How do I recognize a ValuePoint
by MultiPlan member?" |
| A: | | Each member
will have an ID card featuring the ValuePoint by MultiPlan logo along with our client's logo,
typically on the front of the card. The ValuePoint by MultiPlan logo is different than MultiPlan's
standard ID card logo, so you can clearly distinguish an access card member from a member with a
traditional group benefit plan that uses MultiPlan as its network. The member may also have a
confirmation letter from our client to present to you at the time of service. If a member can't
demonstrate that they are in a program that uses the ValuePoint by MultiPlan network, you are not
expected to make your MultiPlan contracted rates available to that individual. |
| Q: | | "Am I required to provide
service to the ValuePoint by MultiPlan member? What if he/she can't pay me?" |
| A: | | As long as
the member meets your tests for proof of an ability to pay and pays for services according to the
arrangements you establish, presentation of a ValuePoint by MultiPlan ID card obligates you to
accept your MultiPlan rates as reimbursement in full for the services provided. You maintain full
control over the financial arrangements you establish with the member, and it is solely your option
if you want to bill the member in lieu of immediate payment where immediate payment would be
feasible. If you are a hospital, you also maintain your right to refuse elective admissions, and
if members do not comply with agreed upon arrangements, you may revert to your normal charges.
Members are clearly informed of these requirements prior to their contacting your facility. |
| Q: | | "What are the fees I am
agreeing to provide the ValuePoint by MultiPlan member?" |
| A: | | Your
MultiPlan contracted rates apply to the ValuePoint by MultiPlan program, so you don't need to
administer a different set of rates. You can obtain a copy of your contracted rates from MultiPlan
if you don't already have them, or simply call our clients' toll-free service centers to request
the rates as needed. Our clients are required to make available to you a call center with the
ability to answer your calls and provide the MultiPlan contracted rates within 2-3 minutes depending
on how many services you need priced. If you prefer, you can submit information to our clients for
repricing on your behalf. This will result in an Explanation of Service sent both to your billing
office and the patient. Your billing office will use this document to bill the patient. |
| Q: | | "How do I collect payment from
the ValuePoint by MultiPlan member?" |
| A: | | The member
is told that you will expect payment in full at the time of service for services not covered by
an insurance plan. If the member is accessing ValuePoint as a complement to an insurance program,
and the services are covered by the plan, he/she may assign benefits to you and you will submit
the claim for reimbursement for the covered portion from the insurer. You can collect any point
of service ValuePoint-related payment in the same manner you accept any other payments - cash,
check, credit card. At your option, you can bill the patient or set up another payment arrangement. |
| Q: | | "How does participation change
my contract with MultiPlan?" |
| A: | | By agreeing
to participate in the ValuePoint by MultiPlan program, you are agreeing to amend your MultiPlan
contract to honor your MultiPlan contracted rates for qualifying ValuePoint by MultiPlan program
members. |
| Q: | | "Can I get out of the program
once I've agreed to participate?" |
| A: | | Yes. If at
any time you decide the program is not viable for you, simply contact MultiPlan Customer Service
at 800-546-3887 and request a form to be removed from the program. Once we receive your signed
form, you will be removed from the program's listings within 35 days. |
