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How does the process work for providers – doctors, hospitals, etc.?
This process is truly as simple as placing your service for sale on the market at whatever price you see fit. This process allows you to sell on an open market just as if you were selling a stock.
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How does the process work for payers – insurance companies, government purchasers, etc.?
This process is also simple. Payers can see what health care is available, put a bid in for a price they want and purchase (reimburse) at a lower price than they already are. This requires no change in they way they currently function. Payers can still review care, require pre-certifications, etc.
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Why would Doctors sell into a market place?
We believe this question to be basically self-evident. Any provider of health care who was given the opportunity to collect on his services at delivery, fully knowing what he would receive and without the added cost and time of billing would do so without question. As an example, a Houston hospital recently approached Blue Cross of Indiana with an offer to perform all of its bypass surgery for half of what Blue Cross would normally pay. This type of competition needs to be placed in an open market. All providers experience annual write-offs of 25%-55% on gross billings and these generally occur after an expensive billing process that lasts 30-120 days until payment is received. Preliminary indications on providers who have been polled suggest that many providers would be willing to “sell” their services for 75-85% of Medicare if they were paid immediately and did not have to bill for services. This rate is a very large reduction in the reimbursement rates that can be found in the marketplace today and represent 20-40% less than some of the toughest contracted rates in the industry!
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Why would insurers buy from this market place?
This answer can be given in one word. Price. Insurers will be inclined to buy (reimburse) through our system due the reduced cost of payment to providers. Over time it will become obvious that this is a much simpler process and this will also encourage insurance companies to utilize it more frequently. This will also change nothing about how insurers do business except that they will pay immediately.
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