Topics:

Hospital Billing Errors
Medical Bill Review
Reference-based pricing
Price Transparency
Network Discount Model
Chargemaster
Balance Billing
Cost Savings

In this episode, Michael introduces you to Dr. Merrit Quarum,  Founder and CEO of WellRithms Inc. Join us as we discuss how WellRithms endeavors to transform healthcare through Hospital medical bill review and transparent and economically sustainable reimbursement practices.
Here’s a glance at what we discuss in this episode:

Dr. Quarum’s diverse health care experience and why he founded WellRithms
What is wrong with our healthcare delivery system as it pertains to affordability, reimbursement, and lack of price transparency
How WellRithms provides an integrated facility medical bill review and establishes a reasonable reimbursement amount for medical services
Why detailed facility medical bill reviews may not be happening with traditional TPA’s and networks and they may not be protecting an employer from unreasonable charges
Examples of Hospital medical bill errors and why auditing is so valuable
The prevalence of Hospital medical bill errors
The average amount of cost savings WellRithms medical bill review yields clients
The difference between reference-based pricing compared to traditional network reimbursement pricing
Why reference-based pricing based on Medicare multiples may pose a problem if the facility or hospital challenges the reimbursement  
WellRithms reference-based pricing methodology compared to traditional reference-based pricing and why WellRithms methodology is legally defensible, backed by case-law
How the WellRithms methodology of pricing is fully indemnifiable and the employer and employee is protected when a Facility challenges the reimbursement level
The types of savings an employer can achieve relative to the Network Discount Model
Myths about balance billing with reference-based pricing and how egregious balance billing scenarios frequently happen in a network discount model
How a self-insured program with WellRithms reimbursement structure compares to capitation models
WellRithms unique cost structure and who they are a good fit for
WellRithms...

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