Next Level Prime

Reference-Based Pricing – August PRIME Time Recap

Listen as Karen Rakers, MD sits down with ClaimDOC Senior Vice President, Omar Arif, to discuss the employer cost savings of PRIME, how RBP is administered through PRIME’s Direct Primary Care model, and the impact these solutions have on the workforce!

Topics Covered in the Video

  • Why are traditional network plans so unaffordable?
  • What is reference-based pricing?
  • How does direct primary care and reference-based pricing work well together?
  • How does PRIME help make a reference-based pricing plan easier to administer?
  • How does one make sure referrals get to RBP-friendly specialists? 
  • What are the typical cost savings of this kind of partnership for an employer?
  • What is the impact of the combined solution on the working class?
  • Why are more brokers not offering this type of solution?
  • What do you think sets PRIME apart from other DPC practices you have worked with?

What is Reference-Based Pricing?

The cost of employee healthcare claims plays a critical role in the price employers pay for benefits. However, understanding the actual cost of a healthcare claim can be extremely challenging. Reference-based pricing (RBP) is an alternative to traditional healthcare pricing, where reimbursement rates for medical services are based on a pre-established benchmark rather than a provider’s charge.

Make Direct Primary Care Work For Your Organization

Our PRIME team is standing by to answer your questions, take you through next steps, and equip your organization with a healthy and robust team. Click below to get in touch with us.

Let's Chat PRIME!

Our Relationship With ClaimDOC

As a Next Level PRIME partner, ClaimDOC works closely with over 600 PRIME members on a variety of levels, including referenced-based pricing and its administration through PRIME’s robust care model. ClaimDOC was founded in 2013 to offer plan sponsors suffering from the rising costs of healthcare an effective and sustainable alternative. Today, employers turn to ClaimDOC seeking to establish fair reimbursement rates for their plans, allowing them to save money and provide richer benefits to their employees.

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