Plan Experiences and Cost Transparency

Regardless of what a Member pays in relation to their Summary of Benefits, the Employer (the Plan) is responsible for the full cost of any procedure or medical service. These medical costs are a main component in determining Health Insurance Premiums. Lowering the medical costs, therefore lowers the Health Insurance Premium.

Through expert care coordination and negotiating medical costs upfront, we can achieve significant savings for our members and employers. The results speak for themselves! 

Recent Member/Employer Plan Experiences

EMERGENCY HOSPITAL SURGERY

Provider Estimate: $9,280
Negotiated Cash Payment: $3,158

Member Responsibility: $500

Savings for the Plan: $6,122

LUMBAR SPINE INFUSION

Provider Estimate: $58,358
Negotiated Cash Payment: $35,015

Member Responsibility: $0

Savings for the Plan: $23,343

PEDIATRIC EAR SURGERY

Provider Estimate: $13,109
Negotiated Cash Payment: $8,783

Member Responsibility: $0

Savings for the Plan: $4,326

HYSTEROSCOPY ABLATION

Hospital Estimate: $30,236
Negotiated Cash Payment: $9,680

Member Responsibility: $500

Savings for the Plan: $20,556

BACK SURGERY

Provider Estimate: $129,893
Negotiated Cash Payment: $64,946

Member Responsibility: $500

Savings for the Plan: $64,947

COLONOSCOPY

Provider Estimate: $5,895
Negotiated Cash Payment: $700

Member Responsibility: $0

Savings for the Plan: $5,195

ROBOTIC PROSTATECTOMY

Provider Estimate: $5,492
Negotiated Cash Payment: $3,296

Member Responsibility: $0

Savings for the Plan: $2,196

PREGNANCY/DELIVERY/NICU

Hospital Estimate: $27,271
Negotiated Cash Payment: $7,390

Member Responsibility: $1,500

Savings for the Plan: $19,881

CYST EXCISION

Surgery Estimate: $31,758
Negotiated Cash Payment: $10,172

Member Responsibility: $500

Savings for the Plan: $21,586

TUNNEL CV CATH REMOVAL

Hospital Estimate: $6,511
Negotiated Cash Payment: $1,923

Member Responsibility: $0

Savings for the Plan: $4,598

Data provided by Ovation Health.