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Telehealth, Advocacy, & Other
Non-Insurance Benefits Your Clients Need Now
Reid Rasmussen
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Ups & Downs of Benefits in 2014+
Medical Rates
OOP$ Employee
Contribution
Doctors First Dollar
Services
HR Time
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What Are Non-Insurance Services?
Discounts Lifestyle Telehealth / Advocacy
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What is Telehealth?
Call 24/7, consult with a U.S. doc
& get a prescription written, if needed.
This is NOT Insurance.
with or without consult fee ( )
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How Much Can Telehealth Save?
2 out of 3 doctor visits can be handled by phone 3.4
0.4 71% ER patients didn’t require emergency attention, Truven Health Analytics, 2013 70% or more Dr. Office visits are unnecessary, WELCOA, 2008
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This is NOT Insurance.
Average medical savings per call: $237 Cost of 4 hours lost productivity: $88
……………………………..……………………..………………….…………………
EVERY CALL SAVES: $325
!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"!!!!!!!!!!"
If they didn’t use Teladoc, where would these people have gone?
*Per Teladoc member reporting. Individual results may vary.
8% ER Visit ……………..……
42% Urgent Care ……………..……
39% Office Visit ……….……….…
11% Do Nothing ………..…………
$1,477/visit
$163/visit
$131/visit
What would these visits have cost?
$? Unknown future cost of neglected issues
How Does Telehealth Save?
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Discounts Lifestyle
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Telehealth / Advocacy
What Are Non-Insurance Services?
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What is Advocacy?
A health advocate helps consumers
navigate “the system”: medical care, price transparency, bills, insurance, & more!
This is NOT Insurance.
Unbiased advice & expert guidance!
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obtain 2nd opinion consults
research conditions & treatments
get cost estimates
assist with eldercare
negotiate medical bills
resolve claims ?s & issues
find health & dental providers
schedule appointments & transfers
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How Does Advocacy Help?
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MEMBER ISSUE 2:
A member needed an MRI & 2 ultrasounds. Her doctor referred her to an imaging center that would cost $800.
RESOLUTION:
The member asked her Advocate if this was the best option & he found estimates with 2 other local in-network centers for $600 or $950.
Original Cost: $800 Selected Cost: $600
How Does Advocacy Save?
MEMBER ISSUE 1:
A member required care at an out-of-network ambulatory surgery center.
RESOLUTION:
Negotiation saved significant amounts off usual charges. Plus, the provider agreed to accept lower fees & not balance bill the member or the plan.
Billed Charges: $60,715 Negotiated Amount: $40,072
34% SAVINGS:
$20,643
EMPLOYERS & EMPLOYEES SAVE TIME, MONEY & FRUSTRATION!
25% SAVINGS:
$200
38% SAVINGS:
$1,245
MEMBER ISSUE 3:
Following surgery, an employee received a large bill from a non-participating anesthesia group.
RESOLUTION:
The Advocate negotiated an arrangement that reduced the member’s responsibility.
Billed Charges: $3,275 Negotiated Amount: $2,030
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What Are Non-Insurance Services?
Discounts Lifestyle Telehealth / Advocacy
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Where Did Discounts Come From?
• 20+ Year Industry • History of Resellers • 2002: “Consumer Health Alliance”
– Discount Medical Plan Organizations – Compliant to Oklahoma Regulators
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What Are Non-Insurance Services?
Discounts Lifestyle Telehealth / Advocacy
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Case Studies
don’t sell a product
solve a problem
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12x2=1,000
TN Agent
Ease move to higher OOP$
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1,000+
Small Agent East Texas
ASK: With every medical case
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1,200
Aspect Software
Keep employees at work & engaged
*Non 5500-able
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52 : 28
Small Manufacturer
Benefit for non-medical employees
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Dallas Broker
Prospect with fresh strategy
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18 mo 13
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300 Rural
North State Grocery
Large groups save claims $
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Non-Insurance Benefits
Your Clients Need Them Now
Reid Rasmussen
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