Or How to Pay the Lowest Price without Sacrificing Quality –

If you’re like most Americans, you’re shouldering a larger portion of your health care costs every year.  As these costs skyrocket, Employers Resource wants you to know that you have some control over what you spend each month, and we’ve added incentives to our plans this year to participants of our plans today’s tough economic times.   

The problem with health care today is that most Americans have no idea how much medical care actually costs.  For example, if a gas station tried to charge you $10 for a gallon of gas, you’d probably get in your car and drive away.  Unfortunately, in health care, that same situation happens every day.  Patients don’t know what “is”, or “is-not” a fair price, and they end up paying the equivalent of the $10 gallon of gas almost every time they visit the doctor’s office.

Employers Resource is pleased to offer the following sage advice on finding the least expensive care without sacrificing the quality you and your family deserve.  What’s more, by following this advice, you stand to save hundreds, if not thousands of dollars in health related expenses this year alone.

Pick the right provider

1. Make sure everyone you see is in-network. Most people don’t realize how much they actually save by staying within the Employers Resource network of medical professionals.
2. Ask about alternate facilities. Doctors often work at outpatient surgery centers as well as hospitals, and what they charge can vary widely by location.
3. Find lower-cost after-hours care. The average in-network cost of an emergency-room visit is about $933 — which you’d likely pay out of pocket with a high-deductible policy.  However, if you visit an urgent-care center, that average cost comes down to just $71!  Sometimes you need high-level emergency-room care, but not always, and it’s best to know your options before an emergency.
4. Save big at independent facilities. Different facilities charge vastly different prices for x-rays and tests. For example, the average in-network cost of an MRI at a hospital is $1,145, but the average in-network cost at an independent radiology facility is just $560.  The radiologist is the same, the only difference is where the procedure is done…
5. Ask about extra discounts. Employers Resource offers plan participants additional discounts as an incentive to use certain providers.  For example, we identify “Treatment Excellence” physicians and facilities, which are paid for at 100%, and integrative “DoctorsPlus” providers, which save participants more than 80% on their office co-pays.

Save on prescriptions

1. Switch to generic drugs. The savings to Employers Resource plan participants can be huge.  Not only is the price lower (for example, Wal-Mart charges $4 for a 30-day supply of certain generic drugs), but Employers Resource lowers your co-insurance rate on generics.
2. Find therapeutic alternatives. Some brand-name drugs don’t have a generic equivalent yet, but they may have a therapeutic equivalent, which is in the same class of drugs but has different chemical properties.  Always ask your doctor before changing to a therapeutic equivalent.
3. Split your pills.  Ask your doctor if you can save money by cutting any of your pills.  For example, the 30-day cost for 20-milligram tablet is often about the same as the 30-day cost for 40-mg tablets of the same medication.  You may be able to order the larger tablet and split it in half, saving you 50% of the total cost per month.  Always ask your doctor before splitting any medications.
4. Double up. If you’re taking a 20-mg pill twice a day, ask your doctor whether it would be safe to switch to a 40-mg pill once a day.

Get no-fee preventive care

1. Schedule a screening.  Employers Resource now provides certain preventive-care screenings without charging deductibles or co-payments. This includes things like blood-pressure, diabetes and cholesterol tests, mammograms and colonoscopies, flu shots, routine vaccines, well-baby and well-child visits, and other preventive services.  Please refer to the Summary Plan Document (SPD) for details.
2. Cash in on wellness benefits.  Employers Resource offers ToolBox™, a comprehensive health and wellness program to all health benefit plan participants.  ToolBox™ includes a 40-panel blood test, biometric and fitness testing, individual and aggregate reporting, lifestyle management tools and a NCQA certified online education portal.  There is a nominal fee for non-members – call 1-877-701-8686 for additional information on this program.
3. Get help for chronic conditions. If you have a chronic condition, such as diabetes, Employers Resource provides incentives to those who enter the Treatment Excellence program.

Know the rules

1. Get credit for everything. If you have a high-deductible policy, make sure you’re getting the Employers Resource negotiated rate instead of paying the much higher list price, even if you haven’t hit your deductible yet and are covering the cost yourself.
2. Watch out for common errors.  Employers Resource recommends that you always request an itemized bill when you have a hospital stay or major procedure — and question unexpected charges!
3. Ask for a cash discount. If you’re in your deductible period and paying for a test or procedure yourself, get some leverage by paying cash.  Make sure you’re getting the Employers Resource negotiated rate, and submit the claim to CNIC yourself so that it counts against your deductible.
4. Negotiate a lower payment. After getting the bill, ask the provider or hospital for a break if you pay a lump sum right away.  Employers Resource recommends that you start by offering them 50% and go from there.
5. Play by the rules.  Review your Employers Resource SPD document annually, and become familiar with the rules regarding emergency care and pre-authorization.  By doing this, you’ll have a plan in place before an emergency, and you won’t get stuck with any “extra charges”, just because you didn’t know the drill.

Do some homework

1. Use the tools available on the Employers Resource Web site.  Employers Resource and our partner, Integrative Health Consultants, Inc. (IHC) provide plan participants with personalized tools to help members shop for care.  For example, members can look up integrative physicians and medical professionals in every town and city across the United States.
2. Sign up for the tools offered by Employers Resource.  Our Treatment Excellence program was developed in partnership with nationally recognized medical experts.  The centers are used to provide a valuable second opinion, as well as targeted surgical procedures (knee, hip, back and gall-bladder) and cancer detection and treatment (prostate and breast).  See our website or your plans individual SPD document for additional details.