| 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 website's Provider Search. Our clients may also host their own website searches and/or call centers 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. Our client may call you within 24 hours of the selection
to alert you to the member's interest, confirm the member's eligibility, and answer any questions
you may have about the program. Otherwise you will be able to confirm the member's eligibility when
he/she arrives at the appointment and presents an ID card displaying a toll free number for
eligibility inquiries or a confirmation letter generated by our client. |
| 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. Our client may call you within 24 hours of the selection to alert you to the member's
interest, confirm the member's eligibility, and answer any questions you may have about the program.
Otherwise you will be able to confirm the member's eligibility when he/she arrives at your facility
and presents an ID card displaying a toll free number for eligibility inquiries or a confirmation
letter generated by our client. 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
clearly informed that the discounts are 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. 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 the toll-free number on the ID card to request the rates
as needed. This will be either MultiPlan's dedicated call center or our clients' call centers call
center with the proven ability to answer most calls within 30 seconds. |
| 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: | | "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. |
