Join FairPrice
Interested in growing your practice by accepting our new patients? Register here to join our open market of doctors and healthcare providers. Complete the registration form, and we’ll send you a confirmation email with just a few steps to complete account setup.
How Fairprice Works
1. How Reference-Based Pricing Works
With reference-based pricing plans, a consumer’s insurance will pay a percentage of Medicare (MRBP). Doctors and healthcare providers that accept reference-based pricing would also set a MRBP percentage for payment.
For example, let’s say a plan will pay up to 120% MRBP. If your rate is set to 120% MRBP, the consumer’s plan will pay the full amount, minus any applicable copays.If you set your rate to 150% MRBP, the consumer is responsible for the difference between the plan’s percentage of MRBP and your percentage of MRBP, plus any applicable copay.
2. Getting Payment
Simply put, you set your price and get paid. No negotiating fee schedules. Bonus: clean claims are paid within 30 days.
With reference-based pricing insurance plans, all but the largest employers use a third-party administrator (TPA) for claims payments. When you see the FairPrice logo on a patient’s benefits card, you know the TPA is an approved payer and may be contacted for benefit verification and payment.You submit your bill to the TPA and they will pay up to the plan’s set MRBP, less any applicable copay.
3. Calculating Your %
With FairPrice, pricing is simple – we have FAIR reimbursements by market to be paid in full for your services. But what should your price be?
Most providers accept the market pricing we pay in your market. By targeting reimbursements by market to be FAIR and concentrating our efforts in a target market (50-250 employees) that has fewer insured individuals, leading to more uninsured, underinsured and Medicaid insured, FairPrice will be an uplift to your payments in aggregate.
While it may be challenging to determine the right price, remember it’s flexible. You can change it if you are not seeing the results you want.
Join FairPrice
Interested in growing your practice by accepting our new patients? Register here to join our open market of doctors and healthcare providers. Complete the registration form, and we’ll send you a confirmation email with just a few steps to complete account setup.
